Ryan J Broyles, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2007018335 Issued in MO

Practice address

1309 Village Dr
Saint Joseph, MO 64506-2457

Phone

(816) 279-2339

Fax

(816) 279-0110

NPI assigned

May 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Indiana University - School of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bennett Eyecare Midwest LLCGroup PAC ID 5890840185, 7 clinicians

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.

• Bennett Eyecare Midwest LLC

  • Optometrist
  • Gladstone, MO
  • NPI 1578598041
  Medicare reassignment Care Compare group NPD
• Bennett Eyecare Midwest LLC

  • Optometrist
  • Kearney, MO
  • NPI 1770363756
  NPD
• Mid America Eye Center PA

  • Ophthalmology Physician
  • Prairie Village, KS
  • NPI 1215967229

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1750548871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 VILLAGE DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062457",
            "telephone_number": "816-279-2339",
            "fax_number": "816-279-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 VILLAGE DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062457",
            "telephone_number": "816-279-2339",
            "fax_number": "816-279-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "RYAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-16",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2007018335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler A. Brown, M.D.
• William G Brown, MS
• Cynthia Marie Brownfield, MD
• Dana L Browning, DDS
• Gregory D. Brownsberger, D.D.S.
• Alexys Brozanic
• Tate Parker Brunelle, DDS
• Paul T Brungardt
• Robert Lee Brunker, D.D.S.
• Alyssa Bryan, OTD, OTR/L

• Optometrist in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.