NPIMap

Organization Active NPI

American Eyecare PC

  • Optometrist
  • Burlington, IA
National Provider Identifier
1881789667
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
IA1667 Issued in IA
Legal business name
AMERICAN EYECARE PC
Doing business as
American Eyecare PC
Practice address
2743 Mount Pleasant St
Burlington, IA 52601-2137
Phone
(319) 754-2020
Fax
(319) 754-2299
NPI assigned
Oct 4, 2006
Last updated
Jan 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Kevin Todd Jennings, ODNPI 1801874714
Title
Optometrist/President
Phone
(319) 754-2020

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IA1667 IA Primary

Addresses

Primary practice location

2743 Mount Pleasant St
Burlington, IA 52601-2137

Mailing address

2743 Mount Pleasant St
Burlington, IA 52601-2137
Phone (319) 754-2020

Other identifiers 2

IdentifierTypeStateIssuer
1080523MedicaidIA
CP7444OtherIARR MEDICARE

Other names 1

  • American Eyecare PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040212000894 IA Part B Supplier - Clinic/Group Practice 5597659151 Receives reassigned benefits from 17 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burlington, IA; Fort Madison, IA; Keokuk, IA; Mt Pleasant, IA
O20100930063088 IA DME Supplier - Physician - OptometristDME Supplier - Optician 5597659151 Practice locations: Burlington, IA

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1009521American Eyecare2743 Mount Pleasant Street, Burlington, IA 52601Certificate of waiverOct 24, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
American Eyecare PC2743 Mount Pleasant St, Burlington, IA 52601-2137(319) 754-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1992

National Provider Directory

National Provider Directory
Tax ID family
David L McManis OD4 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 5

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1881789667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 MOUNT PLEASANT ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526012137",
            "telephone_number": "319-754-2020",
            "fax_number": "319-754-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 MOUNT PLEASANT ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526012137",
            "telephone_number": "319-754-2020",
            "fax_number": "319-754-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "319-754-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "IA1667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1080523",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CP7444",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Eyecare PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.