Bryan Paul Pechous, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

26857 Issued in IA

Practice address

300 North Grandview Avenue
Dubuque, IA 52001-6397

Phone

(563) 588-4675

Fax

(563) 588-1195

NPI assigned

Jan 17, 2006

Last updated

Dec 16, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ophthalmology PC

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  Authorized official Same address or phone
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  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1780664805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NORTH GRANDVIEW AVENUE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016397",
            "telephone_number": "563-588-4675",
            "fax_number": "563-588-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTH GRANDVIEW AVENUE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016397",
            "telephone_number": "563-588-4675",
            "fax_number": "563-588-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECHOUS",
        "first_name": "BRYAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "26857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055517",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jolene Ann Patterson
• Gregory Don Paulsen, M.D.
• Holly Paulsen
• Paige Pavlish
• Halie Jo Paw
• Peckosh Pediatric Dentistry, P.C.
• Valerie Budar Peckosh, DMD
• Karina Irma Perez
• Michael Stephen Peroski, DO
• Sarah Perreault

• Ophthalmology Physician in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Ophthalmology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.