NPIMap

Organization Active NPI

Bruce Boyle, OD. LLC

  • Optometrist
  • Wichita, KS
National Provider Identifier
1558670760
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1473-3 Issued in KS
Legal business name
BRUCE BOYLE, OD. LLC
Practice address
2757 S Seneca St
Wichita, KS 67217-2862
Phone
(316) 260-6280
Fax
(316) 665-6806
NPI assigned
Oct 5, 2010
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Dr. Robert Bruce Boyle, ODNPI 1033203757
Title
Owner/Doctor
Phone
(316) 260-6280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1473-3 KS Primary

Addresses

Primary practice location

2757 S Seneca St
Wichita, KS 67217-2862

Mailing address

2757 S Seneca St
Wichita, KS 67217-2862
Phone (316) 260-6280

Other identifiers 4

IdentifierTypeStateIssuer
100363120-EMedicaidKS
KS4733OtherKSEYE MED
545740OtherKSCOVENTRY
5062OtherKSPREFERRED HEALTH SYSTEMS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Bruce Boyle OD Inc.2757 S Seneca St, Wichita, KS 67217-2862(316) 260-6280 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Oct 1, 1986

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1558670760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 S SENECA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672172862",
            "telephone_number": "316-260-6280",
            "fax_number": "316-665-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 S SENECA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672172862",
            "telephone_number": "316-260-6280",
            "fax_number": "316-665-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE BOYLE, OD. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "316-260-6280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1473-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100363120-E",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "KS4733",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "545740",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH SYSTEMS",
            "identifier": "5062",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.