NPIMap

Organization Active NPI

McPeak Vision Partners PLLC

  • Ophthalmology Physician
  • Glasgow, KY
National Provider Identifier
1801871389
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MCPEAK VISION PARTNERS PLLC
Practice address
108 Bravo Blvd
Glasgow, KY 42141-3478
Phone
(270) 651-2181
Fax
(270) 651-2183
NPI assigned
Dec 7, 2005
Last updated
Mar 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Joseph Gira, MDNPI 1861481152
Title
President/Owner
Phone
(314) 909-0633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X KY
Optician 156FX1800X KY
Ophthalmology Physician 207W00000X KY Primary
Eyewear Supplier 332H00000X KY

Addresses

Primary practice location

108 Bravo Blvd
Glasgow, KY 42141-3478

Mailing address

108 Bravo Blvd
Glasgow, KY 42141-3478
Phone (270) 651-2181

Other practice location 1

1403 Andrea St
Bowling Green, KY 42104-3335
Phone (270) 781-4909

Other identifiers 2

IdentifierTypeStateIssuer
71100171690MedicaidKY
7100171700MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040928000085 KY Part B Supplier - Clinic/Group Practice 5092784033 Receives reassigned benefits from 4 practitioners
Practice locations: Bowling Green, KY; Glasgow, KY
O20100930040773 KY DME Supplier - Physician - Optometrist 5092784033 Practice locations: Glasgow, KY

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

925 Fairview Ave
Bowling Green, KY 42102
Phone (270) 781-2220

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1801871389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BRAVO BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413478",
            "telephone_number": "270-651-2181",
            "fax_number": "270-651-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BRAVO BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413478",
            "telephone_number": "270-651-2181",
            "fax_number": "270-651-2183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 Andrea St",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421043335",
            "country_code": "US",
            "telephone_number": "270-781-4909",
            "fax_number": "270-843-9678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MCPEAK VISION PARTNERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "GIRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "314-909-0633",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71100171690",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100171700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.