Dawn A. Ertel, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2002000793 Issued in MO

Practice address

3465 NE Ralph Powell Rd.
Lee's Summit, MO 64064

Phone

(816) 524-7400

Fax

(816) 525-1700

NPI assigned

Oct 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dawn A. Gray Ertel Former name

Medicare fee-for-service enrollment

Enrolled in KS

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chamberlain McDonald Family Eye Care, PAGroup PAC ID 9032008966, 4 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chamberlain McDonald Family Eye Care, PA

  • Optometrist
  • Olathe, KS
  • NPI 1043348659
  Medicare reassignment Care Compare group NPD
• Custom Vision, Inc.

  dba Custom Eyes

  • Optometrist
  • Lee's Summit, MO
  • NPI 1619004280
  NPD (past)
• Bluffton Family Eye Care, LLC

  • Optometrist
  • Bluffton, IN
  • NPI 1780695171
  NPD (past)
• Drake & Associates, Optometrists, P.a.

  dba Custom Eyes

  • Optometrist
  • Lenexa, KS
  • NPI 1649307372
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851487425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16165 S. BRADLEY DR.",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "66062",
            "telephone_number": "913-780-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 NE RALPH POWELL RD.",
            "city": "LEE'S SUMMIT",
            "state": "MO",
            "postal_code": "64064",
            "telephone_number": "816-524-7400",
            "fax_number": "816-525-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTEL",
        "first_name": "DAWN",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2002000793",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1731",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002691A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "ERTEL",
            "middle_name": "A. GRAY",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen L Epperson, M.D
• Krystina Erichsen
• Lisa M Erickson, LCSW
• Erin Neill Bromley, DDS
• Craig A Erisman, PSY.D.
• Alexander Ervin
• Nina Escobar Petersen, LCSW
• Kaylyn Eshraghi
• Abigail Kathryn Eskew, RD, LD
• Essential Chiropractic LLC

• Optometrist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.