Individual provider Active NPI

Alex Jon Uhlenhopp

  • Optometrist
  • Mason City, IA
National Provider Identifier
1578055521
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
091904 Issued in IA
Practice address
422 S Pierce Ave Ste 1
Mason City, IA 50401
Phone
(641) 424-0780
Fax
(641) 424-2345
NPI assigned
Jun 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 091904 IA Primary

Addresses

Primary practice location

422 S Pierce Ave Ste 1
Mason City, IA 50401

Mailing address

422 S Pierce Ave Ste 1
Mason City, IA 50401-2709
Phone (641) 424-0780

Other practice location 1

213 W Main St
Lake Mills, IA 50450-1445
Phone (641) 592-1801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190925001629 IL Practitioner - Optometry 8426304973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

215 Richard a Mautino Dr
Spring Valley, IL 61362-1144
Phone (815) 664-5331

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as individual
Quality
67.44
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eyesite-Illinois Valley, L.L.C. Optometrist CurrentSince Aug 17, 2019 Accepting new patients
Eyesite-Illinois Valley, LLC Optometrist CurrentSince Aug 17, 2019 Accepting new patients

Locations

925 Clinton St
Ottawa, IL 61350
Phone (815) 434-7970

215 Richard a Mautino Dr
Spring Valley, IL 61362
Phone (805) 664-5331

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1578055521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 S PIERCE AVE STE 1",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012709",
            "telephone_number": "641-424-0780",
            "fax_number": "641-424-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 S PIERCE AVE STE 1",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "50401",
            "telephone_number": "641-424-0780",
            "fax_number": "641-424-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 W Main St",
            "address_purpose": "LOCATION",
            "city": "Lake Mills",
            "state": "IA",
            "postal_code": "504501445",
            "country_code": "US",
            "telephone_number": "641-592-1801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UHLENHOPP",
        "first_name": "ALEX",
        "middle_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "091904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.