Individual provider Active NPI

Peter James Thayer, O.D.

  • Optometrist
  • Ankeny, IA
National Provider Identifier
1568774099
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2493 Issued in IA
Practice address
2135 SE Delaware Ave
Ankeny, IA 50021-4592
Phone
(515) 964-0444
Fax
(515) 964-7070
NPI assigned
Jul 13, 2010
Last updated
Nov 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2493 IA Primary

Addresses

Primary practice location

2135 SE Delaware Ave
Ankeny, IA 50021-4592

Mailing address

2912 35TH St
Des Moines, IA 50310-4003
Phone (515) 451-4241

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
I20101122000062 IA Practitioner - Optometry 6608062351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus Eye Care PCGroup PAC ID 6406100684, 4 clinicians

Practice addresses (Care Compare)

1155 SE Alices Rd
Waukee, IA 50263-9669
Phone (515) 264-2445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2493IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thayer Eye Care Optometrist CurrentSince Jan 21, 2022 Accepting new patients
Focus Eye Care PC Optometrist CurrentSince Oct 1, 2018 Accepting new patients
Thayer Eye Care Optometrist Current Accepting new patients

Locations

2135 SE Delaware Ave
Ankeny, IA 50021
Phone (515) 964-0444

1155 SE Alices Rd
Waukee, IA 50263
Phone (515) 264-2445

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1568774099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 35TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503104003",
            "telephone_number": "515-451-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 SE DELAWARE AVE",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500214592",
            "telephone_number": "515-964-0444",
            "fax_number": "515-964-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "2493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.