Individual provider Active NPI

Joo Won L Kaser, O.D.

  • Optometrist
  • Overland Park, KS
National Provider Identifier
1629090097
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2158 Issued in KS
Practice address
11500 W 119TH St
Overland Park, KS 66213-2002
Phone
(913) 451-0001
NPI assigned
Jul 24, 2006
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2023007228 MO
Optometrist 152W00000X 2158 KS Primary

Addresses

Primary practice location

11500 W 119TH St
Overland Park, KS 66213-2002

Mailing address

11500 W 119TH St
Overland Park, KS 66213-2002
Phone (913) 451-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20231213003837 KS Practitioner - Optometry 9830192202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burlingame and Mock Vision Associates, IncGroup PAC ID 0547336547, 5 clinicians

Practice addresses (Care Compare)

11500 W 119TH St
Overland Park, KS 66213-2002
Phone (913) 451-0001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023007228MOMDOptometrist
2158KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Burlingame & Mock Vision Associates, Inc Optometrist CurrentSince Nov 16, 2023 Accepting new patients

Locations

11500 W 119th St
Overland Park, KS 66213
Phone (913) 451-0001

Interoperability endpoints

  • Direct secure messaging: joo.won.lee.kaser.1@16003.direct.athenahealth.com

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, 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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1629090097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132002",
            "telephone_number": "913-451-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132002",
            "telephone_number": "913-451-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASER",
        "first_name": "JOO WON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2023007228",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.