Bryan Scott Koontz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2494 Issued in AR

Practice address

924 Main St
Conway, AR 72032-5424

Phone

(501) 327-4444

Fax

(501) 327-3962

NPI assigned

Nov 30, 2005

Last updated

Jan 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Optometry

Education

Southern College of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shane E Ford OD PAGroup PAC ID 3678529575, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.4 of 100Reported as group

Quality

95

Improvement activities

40

Cost

71.33

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shane E. Ford OD PA

  dba Arkansas Eye Care Group

  • Optometrist
  • Conway, AR
  • NPI 1033178736
  Medicare reassignment Care Compare group NPD
• Shane E. Ford OD PA

  dba Arkansas Eye Care Group

  • Optometrist
  • Greenbrier, AR
  • NPI 1821801424
  NPD

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1609850916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 MAIN ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325424",
            "telephone_number": "501-327-4444",
            "fax_number": "501-327-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 MAIN ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325424",
            "telephone_number": "501-327-4444",
            "fax_number": "501-327-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "BRYAN",
        "middle_name": "SCOTT",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137583722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kouhei Kobayashi
• Clint Dawson Koen, DDS
• Malory Diane Kolp, LMSW
• Sudha Srivalli Konakanchi, MD
• Kristina Koon
• Sandra Koontz, CMP
• Brooke Lauren Kordsmeier, PHARM D
• Colton Kordsmeier, MD
• Sarah Kordsmeier
• Kirsten Leigh Kravitz, MSN CPNP

• Optometrist in Conway, AR
• Providers in Conway, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.