Individual provider Active NPI

Robert C Weixeldorfer, OD

  • Optometrist
  • Lees Summit, MO
National Provider Identifier
1528051802
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2001023319 Issued in MO
Practice address
600 NW Murray Rd
Ste 115
Lees Summit, MO 64081-1204
Phone
(816) 478-1230
Fax
(816) 350-4190
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1635 KS
Optometrist 152W00000X 2001023319 MO Primary

Addresses

Primary practice location

600 NW Murray Rd
Ste 115
Lees Summit, MO 64081-1204

Mailing address

4801 S Cliff Ave
Suite 100
Independence, MO 64055-7015
Phone (816) 478-1230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100422000321 MO Practitioner - Optometry 5991832032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care LLCGroup PAC ID 4385544600, 49 clinicians

Practice addresses (Care Compare)

425 NW Murray Rd
Lees Summit, MO 64081-1425
Phone (816) 478-1230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2001023319MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care, LLC Optometrist CurrentSince Jul 1, 2002 Accepting new patients
Eye Care, LLC Optometrist CurrentSince Jul 1, 2002 Accepting new patients
Eye Care LLC Optometrist Past Accepting new patients

Locations

11500 Granada St
Leawood, KS 66211
Phone (816) 350-6902

670 S Commercial St
Harrisonville, MO 64701

4801 S Cliff Ave
Ste 100
Independence, MO 64055
Phone (816) 350-4536

4741 S Cochise Dr
Independence, MO 64055
Phone (816) 542-2849

425 NW Murray Rd
Lees Summit, MO 64081
Phone (816) 542-7157

600 NW Murray Rd
Ste 115
Lees Summit, MO 64081

Interoperability endpoints

  • Direct secure messaging: rweixeldorfer@direct.dvc.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1528051802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S CLIFF AVE",
            "address_2": "SUITE 100",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557015",
            "telephone_number": "816-478-1230",
            "fax_number": "816-478-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NW MURRAY RD",
            "address_2": "STE 115",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640811204",
            "telephone_number": "816-478-1230",
            "fax_number": "816-350-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIXELDORFER",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1635",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2001023319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.