Individual provider Active NPI

Breanne Michelle Niebuhr, O.D.

  • Optometrist
  • Overland Park, KS
National Provider Identifier
1548436561
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1178 Issued in KS
Practice address
5808 W 110TH St
Overland Park, KS 66211-2504
Phone
(913) 696-8000
Fax
(816) 302-9939
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1178 KS Primary
Low Vision Rehabilitation Optometrist 152WL0500X 1178 KS

Addresses

Primary practice location

5808 W 110TH St
Overland Park, KS 66211-2504

Mailing address

2401 Gillham Rd
Provider Enrollment
Kansas City, MO 64108-4619
Phone (816) 701-5211

Other names 1

  • Dr. Breanne Michelle Paul Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20080725000264 KS Practitioner - Optometry 0749353621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milton B Grin MD PAGroup PAC ID 3870493752, 11 clinicians

Practice addresses (Care Compare)

21020 W 151St St
Grin Eye Care
Olathe, KS 66061-7200
Phone (913) 829-5511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.14 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1178KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Milton B Grin MD PA CurrentSince Sep 27, 2010 Accepting new patients

Locations

13400 Briar Dr
Ste C
Leawood, KS 66209
Phone (913) 829-5511

21020 W 151st St
Olathe, KS 66061
Phone (913) 829-3283

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1548436561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5211",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112504",
            "telephone_number": "913-696-8000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBUHR",
        "first_name": "BREANNE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1178",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "KS",
            "license": "1178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNE",
            "last_name": "PAUL",
            "middle_name": "MICHELLE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.