Individual provider Active NPI

Casey Matthew Roelfs, O.D.

  • Optometrist
  • Boone, IA
National Provider Identifier
1881673267
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02185 Issued in IA
Practice address
621 Story St
Boone, IA 50036-2833
Phone
(515) 432-2973
NPI assigned
Jan 12, 2006
Last updated
Jul 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02185 IA Primary

Addresses

Primary practice location

621 Story St
Boone, IA 50036-2833

Mailing address

621 Story St
Boone, IA 50036-2833
Phone (515) 432-2973

Other identifiers 4

IdentifierTypeStateIssuer
410047848OtherRRM RAILROAD MEDICARE
4512050001OtherCIGNA/DMERC
1213785MedicaidIA
27547OtherIABLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100326000510 IA Practitioner - Optometry 0648306837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Vision Center LLCGroup PAC ID 3072506948, 2 clinicians

Practice addresses (Care Compare)

621 Story St
Boone, IA 50036-2833
Phone (515) 432-2973

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02185IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Vision Center LLC Optometrist CurrentSince Jul 1, 2001 Accepting new patients
Nelson Opticians, Inc. Past Accepting new patients
Boone Vision Center PastSince Jul 1, 2001 Accepting new patients

Locations

2721 Stange Rd
Ste 101
Ames, IA 50010
Phone (515) 292-3718

3324 Orion Dr
Ste 2
Ames, IA 50010
Phone (515) 232-4003

621 Story St
Boone, IA 50036
Phone (515) 432-2973

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1881673267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 STORY ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500362833",
            "telephone_number": "515-432-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 STORY ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500362833",
            "telephone_number": "515-432-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELFS",
        "first_name": "CASEY",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM RAILROAD MEDICARE",
            "identifier": "410047848",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/DMERC",
            "identifier": "4512050001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1213785",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "27547",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, IA

Sources for this page

Verify at the official NPI Registry.