Larry Don Peck, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1719 Issued in IA

Practice address

716 Avenue G
Fort Madison, IA 52627-2927

Phone

(319) 372-2321

Fax

(319) 372-2850

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Optometry

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• L.D Peck,PC

  • Optometrist
  • Keokuk, IA
  • NPI 1215008164
  Medicare reassignment NPD Authorized official
• L.D Peck,PC

  • Optometrist
  • Fort Madison, IA
  • NPI 1992281984
  NPD

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730174129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 AVENUE G",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526272927",
            "telephone_number": "319-372-2321",
            "fax_number": "319-372-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 AVENUE G",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526272927",
            "telephone_number": "319-372-2321",
            "fax_number": "319-372-2850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1813 Main St",
            "address_purpose": "LOCATION",
            "city": "Keokuk",
            "state": "IA",
            "postal_code": "526323326",
            "country_code": "US",
            "telephone_number": "319-524-3651",
            "fax_number": "319-524-6118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "LARRY",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2900894",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fort Madison, IA
• Providers in Fort Madison, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.