Individual provider Active NPI

Raymond J Brill, OD, FAAO, FOAA

  • Optometrist
  • Mission, KS
National Provider Identifier
1871617787
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1132-3 Issued in KS
Practice address
5820 Lamar Ave Ste 100
Mission, KS 66202-2647
Phone
(913) 432-7676
Fax
(913) 432-7717
NPI assigned
Mar 17, 2007
Last updated
May 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1132-3 KS Primary
Corneal and Contact Management Optometrist 152WC0802X 1132-3 KS
Pediatric Optometrist 152WP0200X 1132-3 KS

Addresses

Primary practice location

5820 Lamar Ave Ste 100
Mission, KS 66202-2647

Mailing address

5820 Lamar Ave Ste 100
Mission, KS 66202-2647
Phone (913) 432-7676

Other identifiers 1

IdentifierTypeStateIssuer
100219700BMedicaidKS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050715000491 KS Practitioner - Optometry 0244266716 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Acuity Vision Center LLC Optometrist CurrentSince Jun 22, 2021 Accepting new patients
Insight Vision Center LLC Optometrist Past Accepting new patients
Pingel Family Eyecare, LLC Optometrist Past Accepting new patients
Honson & Honson, Inc. Optometrist Past Accepting new patients

Locations

5820 Lamar Ave
Mission, KS 66202
Phone (913) 432-7676

5820 Lamar Ave
Ste 100
Mission, KS 66202
Phone (913) 432-7676

11114 S Lone Elm Rd
Olathe, KS 66061
Phone (913) 390-6700

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1871617787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 LAMAR AVE STE 100",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662022647",
            "telephone_number": "913-432-7676",
            "fax_number": "913-432-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 LAMAR AVE STE 100",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662022647",
            "telephone_number": "913-432-7676",
            "fax_number": "913-432-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRILL",
        "first_name": "RAYMOND",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD, FAAO, FOAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1132-3",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "KS",
            "license": "1132-3",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "KS",
            "license": "1132-3",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100219700B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, KS

Sources for this page

Verify at the official NPI Registry.