Individual provider Active NPI

Brian Robert Heintz, OD

  • Optometrist
  • Raymore, MO
National Provider Identifier
1700997582
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO3258 Issued in MO
Practice address
2015 W Foxwood Dr
Raymore, MO 64083-9380
Phone
(816) 322-3039
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO3258 MO Primary

Addresses

Primary practice location

2015 W Foxwood Dr
Raymore, MO 64083-9380

Mailing address

4304 NE 57TH Ter
Kansas City, MO 64119-4681
Phone (816) 452-8979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070614000584 MO Practitioner - Optometry 5092813063 Practice locations: Raymore, MO

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2015 W Foxwood Dr
Raymore, MO 64083-9380
Phone (816) 322-3039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO3258MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Heintz-Sight 20/20, Inc Optometrist Past Accepting new patients
Professional Eyecare Zona Rosa Inc. Optometrist Past Accepting new patients
Zona Rosa Eyecare Inc Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700997582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 NE 57TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641194681",
            "telephone_number": "816-452-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W FOXWOOD DR",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640839380",
            "telephone_number": "816-322-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINTZ",
        "first_name": "BRIAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

Verify at the official NPI Registry.