Individual provider Active NPI

Jeremie Eldon Frazier, O.D.

  • Optometrist
  • Kinsley, KS
National Provider Identifier
1710179726
Registry record updated Dec 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1770 Issued in KS
Practice address
713 Marsh Ave
Kinsley, KS 67547-1129
Phone
(620) 659-3351
NPI assigned
Aug 14, 2007
Last updated
Dec 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1770 KS Primary

Addresses

Primary practice location

713 Marsh Ave
Kinsley, KS 67547-1129

Mailing address

713 Marsh Ave
Kinsley, KS 67547-1129
Phone (620) 659-3351

Other identifiers 1

IdentifierTypeStateIssuer
200540510AMedicaidKS

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
I20080512000401 KS Practitioner - Optometry 8921187279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

713 Marsh Ave
Kinsley, KS 67547-1129
Phone (620) 659-3351

Merit-based Incentive Payment System (MIPS)

Final score
92.77 of 100Reported as individual
Quality
85.54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1770KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Frazier Optometry, PA Optometrist CurrentSince Dec 13, 2013 Accepting new patients
Vierthaler Kessen Optometry, LLC Optometrist PastSince Oct 1, 2019 Accepting new patients

Locations

713 Marsh Ave
Kinsley, KS 67547
Phone (620) 655-5033

Organizations & group practices 2

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386979200000",
    "number": "1710179726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MARSH AVE",
            "city": "KINSLEY",
            "state": "KS",
            "postal_code": "675471129",
            "telephone_number": "620-659-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 MARSH AVE",
            "city": "KINSLEY",
            "state": "KS",
            "postal_code": "675471129",
            "telephone_number": "620-659-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "JEREMIE",
        "middle_name": "ELDON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2013-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200540510A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinsley, KS

Sources for this page

Verify at the official NPI Registry.