Jeffrey Enevoldsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2012017342 Issued in MO

Practice address

3660 NE Ralph Powell Rd
Lees Summit, MO 64064-2357

Phone

(816) 524-7400

Fax

(816) 525-1700

NPI assigned

Aug 2, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paige Hedgpath OdpcGroup PAC ID 5991856460, 25 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Paige Hedgpath OD,PC

  dba Eyes On Missouri

  • Optometrist
  • Jefferson City, MO
  • NPI 1962644732
  Medicare reassignment Care Compare group NPD
• Paige Hedgpath Odpc

  dba Eyes On Missouri

  • Optometrist
  • Columbia, MO
  • NPI 1669530887
  NPD
• Kessler Eyecare PA

  • Optometrist
  • Wichita, KS
  • NPI 1174639975
  NPD (past)
• Kessler Eyecare, P.a.

  • Optometrist
  • Overland Park, KS
  • NPI 1750392643
  NPD (past)

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1558617993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 NE RALPH POWELL RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642357",
            "telephone_number": "816-524-7400",
            "fax_number": "816-525-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 NE RALPH POWELL RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642357",
            "telephone_number": "816-524-7400",
            "fax_number": "816-525-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENEVOLDSEN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-02",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1915",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2012017342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergent Care Plus
• Emergent Care Plus, LLC (NextCare Urgent Care)
• Empowering Parents
• Empowerme Rehabilitation Mo Agency
• Robert Grey Endres, DSW, LCSW
• Amber England, LPC
• Sara C English, OTR/L
• Envision Eyecare, LLC (Envision Eyecare)
• Jennifer I Enyeribe
• Epc Mo Aco LLC

• Optometrist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.