Organization Active NPI

Mooney Eyecare Centre, PLLC

Doing business as Mooney EyeCare Centre

  • Optometrist
  • Mt Washington, KY
National Provider Identifier
1699965335
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1714DT Issued in KY
Legal business name
MOONEY EYECARE CENTRE, PLLC
Doing business as
Mooney EyeCare Centre
Practice address
327 Eastbrooke Dr # 100
Mt Washington, KY 40047-5561
Phone
(502) 538-4362
Fax
(502) 538-3551
NPI assigned
Jul 30, 2007
Last updated
Oct 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Dr. Matthew Lutes Mooney, O.D.NPI 1518166610
Title
Sole Member
Phone
(502) 538-4632

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1714DT KY Primary

Addresses

Primary practice location

327 Eastbrooke Dr # 100
Mt Washington, KY 40047-5561

Mailing address

327 Eastbrooke Dr # 100
Mt Washington, KY 40047-5561
Phone (502) 538-4362

Other identifiers 1

IdentifierTypeStateIssuer
7100026420MedicaidKY

Other names 1

  • Mooney EyeCare Centre Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071022000677 KY Part B Supplier - Clinic/Group Practice 9032205091 Receives reassigned benefits from 8 practitioners
Practice locations: Bardstown, KY; Fisherville, KY; Louisville, KY; Mt Washington, KY; Shelbyville, KY

National Provider Directory

National Provider Directory

Locations

6287 Taylorsville Rd
Ste B1
Fisherville, KY 40023
Phone (502) 354-0508

223 Delaina Dr
Ste B
Mt Washington, KY 40047
Phone (502) 538-4362

327 Eastbrooke Pointe Dr
Ste 100
Mt Washington, KY 40047
Phone (502) 538-4362

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1699965335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 EASTBROOKE DR # 100",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400475561",
            "telephone_number": "502-538-4362",
            "fax_number": "502-538-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 EASTBROOKE DR # 100",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400475561",
            "telephone_number": "502-538-4362",
            "fax_number": "502-538-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONEY EYECARE CENTRE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "MOONEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "LUTES",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "502-538-4632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1714DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100026420",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mooney EyeCare Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Washington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.