NPIMap

Organization Active NPI

Eyecare Associates, Inc.

  • Optometrist
  • Southside, AL
National Provider Identifier
1891862942
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S879TA440 Issued in AL
Legal business name
EYECARE ASSOCIATES, INC.
Practice address
1755 Highway 77
Southside, AL 35907-0169
Phone
(636) 200-4393
Fax
(256) 442-6292
NPI assigned
Nov 30, 2006
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
James WachterNPI 1689670697
Title
Owner
Phone
(636) 200-4393

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 S879TA440 AL Primary

Addresses

Primary practice location

1755 Highway 77
Southside, AL 35907-0169

Mailing address

PO Box 207243
Dallas, TX 75320-7243
Phone (636) 200-4393

Other identifiers 1

IdentifierTypeStateIssuer
009946130MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040823000825 AL Part B Supplier - Clinic/Group Practice 0749254001 Receives reassigned benefits from 88 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntsville, AL; Luverne, AL; Madison, AL; Mobile, AL; Montgomery, AL; Moody, AL; Northport, AL; Ozark, AL…

Other NPIs on the same Medicare enrollment 33

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

View all 33

National Provider Directory

National Provider Directory
Tax ID family
Eye Care Assoicates Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

1755 Highway 77
Southside, AL 35907
Phone (256) 442-6200

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1891862942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207243",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207243",
            "telephone_number": "636-200-4393",
            "fax_number": "256-442-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 77",
            "city": "SOUTHSIDE",
            "state": "AL",
            "postal_code": "359070169",
            "telephone_number": "636-200-4393",
            "fax_number": "256-442-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S879TA440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009946130",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southside, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.