NPIMap

Organization Active NPI

Wolfe Clinic Eye Centers LC

  • Optometrist
  • Marshalltown, IA
National Provider Identifier
1720067424
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WOLFE CLINIC EYE CENTERS LC
Practice address
309 E Church St
Marshalltown, IA 50158-2946
Phone
(641) 754-6200
NPI assigned
Jan 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
David Moench
Title
Chief Financial Officer
Phone
(515) 240-8721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

309 E Church St
Marshalltown, IA 50158-2946

Mailing address

309 E Church St
Marshalltown, IA 50158-2946
Phone (641) 754-6200

Other identifiers 2

IdentifierTypeStateIssuer
0417634MedicaidIA
CI5159OtherIARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000679 IA Part B Supplier - Clinic/Group Practice 1850285479 Receives reassigned benefits from 8 practitioners
3 other NPIs on this enrollment
Practice locations: Belmond, IA; Webster City, IA; Waverly, IA; Story City, IA; Sac City, IA; Grundy Center, IA; Fairfield, IA; Clarion, IA…

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wolfe Clinic Eye CTRS L11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

100 S 23rd St
Fairfield, IA 52556
Phone (515) 472-6151

619 Broad St
Story City, IA 50248
Phone (515) 733-6900

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1720067424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E CHURCH ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501582946",
            "telephone_number": "641-754-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E CHURCH ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501582946",
            "telephone_number": "641-754-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLFE CLINIC EYE CENTERS LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "MOENCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "515-240-8721"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0417634",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI5159",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.