Individual provider Active NPI

Hallie Kuchera, OD

  • Optometrist
  • Waterloo, IA
National Provider Identifier
1568022184
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
096272 Issued in IA
Practice address
2027 Crossroads Blvd
Waterloo, IA 50702-4405
Phone
(319) 505-2142
NPI assigned
Jun 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 096272 IA Primary

Addresses

Primary practice location

2027 Crossroads Blvd
Waterloo, IA 50702-4405

Mailing address

816 Lisa Dr
Waterloo, IA 50701-5212
Phone (319) 296-5960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20190916002193 IA Practitioner - Optometry 3072842178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Augustin Eye Care PLCGroup PAC ID 1658503818, 3 clinicians

Practice addresses (Care Compare)

2027 Crossroads Blvd
Waterloo, IA 50702-4405
Phone (319) 505-2142

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
096272IAMDOptometrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1568022184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 LISA DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015212",
            "telephone_number": "319-296-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 CROSSROADS BLVD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507024405",
            "telephone_number": "319-505-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHERA",
        "first_name": "HALLIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "096272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.