NPIMap

Organization Active NPI

Iowa Eye PC

Doing business as Iowa Eye Center Optical

  • Eyewear Supplier
  • Cedar Rapids, IA
National Provider Identifier
1710007406
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
IOWA EYE PC
Doing business as
Iowa Eye Center Optical
Practice address
1650 1St Ave NE
Cedar Rapids, IA 52402-5431
Phone
(319) 366-2020
Fax
(319) 366-3020
NPI assigned
Mar 29, 2007
Last updated
Mar 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Dawn M Waller
Title
Director of Reimbursement
Phone
(319) 362-3937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary
Prosthetic/Orthotic Supplier 335E00000X NU

Addresses

Primary practice location

1650 1St Ave NE
Cedar Rapids, IA 52402-5431

Mailing address

1650 1St Ave NE
Cedar Rapids, IA 52402-5431
Phone (319) 366-2020

Other identifiers 1

IdentifierTypeStateIssuer
0079418MedicaidIA

Other names 1

  • IOWA EYE CENTER OPTICAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930063883 IA DME Supplier - Physician - OphthalmologyDME Supplier - OpticianDME Supplier - Orthotic Personnel 2668361940 Practice locations: Cedar Rapids, IA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Iowa Eye PC

    dba Iowa Eye Center

    • Ophthalmology Physician
    • Cedar Rapids, IA
    • NPI 1952356982

    2668361940

    Same PAC ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Iowa Eye P.C.1650 1St Ave NE, Cedar Rapids, IA 52402-5431(319) 362-3937 Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1993

National Provider Directory

National Provider Directory
Tax ID family
Iowa Eye PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1710007406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 1ST AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025431",
            "telephone_number": "319-366-2020",
            "fax_number": "319-366-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 1ST AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025431",
            "telephone_number": "319-366-2020",
            "fax_number": "319-366-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA EYE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "319-362-3937"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079418",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IOWA EYE CENTER OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.