Individual provider Active NPI

Tristan M Brown, O.D.

  • Optometrist
  • Carroll, IA
National Provider Identifier
1598781007
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02359 Issued in IA
Practice address
1236 Heires Ave
Carroll, IA 51401-3328
Phone
(712) 792-3318
Fax
(712) 792-3319
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02359 IA Primary

Addresses

Primary practice location

1236 Heires Ave
Carroll, IA 51401-3328

Mailing address

PO Box 669
Carroll, IA 51401-0669
Phone (712) 792-3318

Other identifiers 8

IdentifierTypeStateIssuer
25008OtherIAWELLMARK JEFFERSON
0498287MedicaidIA
25005OtherIAWELLMARK CARROLL
25007OtherIAWELLMARK DENISON
250737OtherIAMIDLANDS CHOICE
1498287MedicaidIA
291300OtherIACOVENTRY ALL OFFICES
2498287MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
T L Brown OD PC Optometrist Past Accepting new patients
Aruba Vision LLC Optometrist PastSince May 7, 2023 Accepting new patients
Carroll Eye Clinic PC Optometrist Past Accepting new patients
Drees Family & Sports Chiropractic, Inc Past Accepting new patients
Family Eye Care of Osceola PC Optometrist Past Accepting new patients
Family Eye Care PC Optometrist PastSince Aug 11, 1997 Accepting new patients

Organizations & group practices 6

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223596800000",
    "number": "1598781007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514010669",
            "telephone_number": "712-792-3318",
            "fax_number": "712-792-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 HEIRES AVE",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013328",
            "telephone_number": "712-792-3318",
            "fax_number": "712-792-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TRISTAN",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK JEFFERSON",
            "identifier": "25008",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0498287",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK CARROLL",
            "identifier": "25005",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK DENISON",
            "identifier": "25007",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "250737",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1498287",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY ALL OFFICES",
            "identifier": "291300",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2498287",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.