Individual provider Active NPI

Andrew Michael Belknap, OD

  • Optometrist
  • Madison, AL
National Provider Identifier
1710479308
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SE02 Issued in AL
Practice address
7880 Old Madison Pike
Madison, AL 35758-1435
Phone
(256) 772-8711
Fax
(256) 772-8738
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SE02 AL Primary

Addresses

Primary practice location

7880 Old Madison Pike
Madison, AL 35758-1435

Mailing address

PO Box 207243
Dallas, TX 75320-7243
Phone (636) 200-4393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180816000959 AL Practitioner - Optometry 8921357419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Associates, Inc.Group PAC ID 0749254001, 52 clinicians

Practice addresses (Care Compare)

7880 Old Madison Pike
Madison, AL 35758-1435
Phone (256) 772-8711

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SE02ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Associates, Inc. Optometrist CurrentSince May 31, 2018 Accepting new patients
Eyecare Associates, Inc. Optometrist Current Accepting new patients
Eyecare Associates, Inc. Optometrist CurrentSince May 31, 2018 Accepting new patients
Eyecare Associates, Inc. Past Accepting new patients

Locations

21 Hughes Rd
Ste 1
Madison, AL 35758
Phone (256) 678-7990

7880 Old Madison Pike
Madison, AL 35758
Phone (256) 772-8711

Interoperability endpoints

  • Direct secure messaging: andrewbelknap@direct.eyecare-partners.com

Organizations & group practices 4

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1710479308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207243",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207243",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7880 OLD MADISON PIKE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581435",
            "telephone_number": "256-772-8711",
            "fax_number": "256-772-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELKNAP",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "SE02",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.