NPIMap

Organization Active NPI

Mattax Neu Prater Eye Center, Inc.

  • Ophthalmology Physician
  • Springfield, MO
National Provider Identifier
1790745313
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MATTAX NEU PRATER EYE CENTER, INC.
Practice address
1265 E Primrose St
Springfield, MO 65804-4278
Phone
(471) 886-3937
Fax
(417) 886-1285
NPI assigned
Mar 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Authorized official

Name
James B Mattax Jr., MDNPI 1346244779
Title
President
Phone
(417) 886-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1265 E Primrose St
Springfield, MO 65804-4278

Mailing address

1265 E Primrose St
Springfield, MO 65804-4278
Phone (471) 886-3937

Other identifiers 2

IdentifierTypeStateIssuer
CI7181OtherMORAILROAD MEDICARE PART B
506240704MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000594 MO Part B Supplier - Clinic/Group Practice 6103713979 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Springfield, MO

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Mattaxneuprater Eye Cen4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1790745313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044278",
            "telephone_number": "471-886-3937",
            "fax_number": "417-886-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044278",
            "telephone_number": "471-886-3937",
            "fax_number": "417-886-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTAX NEU PRATER EYE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "MATTAX",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-886-3937",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PART B",
            "identifier": "CI7181",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506240704",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.