Rebecca L Peck, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

01960 Issued in IA

Practice address

425 So 2ND St
Midwest Vision Clinic PLC
Clinton, IA 52732

Phone

(563) 242-0223

Fax

(563) 242-6864

NPI assigned

Jul 12, 2006

Last updated

Oct 18, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Vision Clinic PLCGroup PAC ID 5294636239, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Midwest Vision Clinic PLC

  • Optometrist
  • Clinton, IA
  • NPI 1245254648
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1639104045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 SO 2ND ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "52732",
            "telephone_number": "563-242-0223",
            "fax_number": "563-242-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 SO 2ND ST",
            "address_2": "MIDWEST VISION CLINIC PLC",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "52732",
            "telephone_number": "563-242-0223",
            "fax_number": "563-242-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01960",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1078253",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "48078",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia K Stark (Killean Audiology & Hearing Aid Center)
• Natalie Paulson
• Kelsey Paysen
• Susan Mary Pebelske
• Brian W Peck, OD
• Bobbi Leanne Pennock
• Jorge H Perez-Cardona, M.D.
• Jennifer Lynn Petersen, DC
• Reese Raymond Petersen, DC
• Mara Lynn Peth, PA-C

• Optometrist in Clinton, IA
• Providers in Clinton, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.