Individual provider Active NPI

Jeffry David Gerson, O.D.

  • Optometrist
  • Olathe, KS
National Provider Identifier
1659378461
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1519-3 Issued in KS
Practice address
21020 W 151St St
Olathe, KS 66061-7200
Phone
(913) 829-5511
Fax
(913) 829-5571
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03413 MO
Optometrist 152W00000X 1519-3 KS Primary

Addresses

Primary practice location

21020 W 151St St
Olathe, KS 66061-7200

Mailing address

21020 W 151St St
Olathe, KS 66061-7200
Phone (913) 829-5511

Other identifiers 1

IdentifierTypeStateIssuer
25144105OtherBLUE CROSS BLUE SHIELD KC

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
I20040812000043 KS Practitioner - Optometry 9234109018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milton B Grin MD PAGroup PAC ID 3870493752, 11 clinicians

Practice addresses (Care Compare)

13400 Briar Dr
Suite C
Leawood, KS 66209-3411
Phone (913) 829-5511

Merit-based Incentive Payment System (MIPS)

Final score
93.14 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1519-3KSMDOptometrist
T03413MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Hawks, Besler and Rogers Optometrist Past Accepting new patients
Eyecare Specialties of Missouri LLC Optometrist Past Accepting new patients
Lake and Lake Optometry PC Optometrist Past Accepting new patients
Mid-America Retina Consultants PA PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 5

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499212800000",
    "number": "1659378461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21020 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617200",
            "telephone_number": "913-829-5511",
            "fax_number": "913-829-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21020 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617200",
            "telephone_number": "913-829-5511",
            "fax_number": "913-829-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSON",
        "first_name": "JEFFRY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03413",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1519-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KC",
            "identifier": "25144105",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.