Individual provider Active NPI

Melissa R Brewer, O.D.

  • Optometrist
  • Overland Park, KS
National Provider Identifier
1902881782
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1678 Issued in KS
Practice address
12621 Antioch Rd
Overland Park, KS 66213-1701
Phone
(913) 814-7707
Fax
(913) 814-7997
NPI assigned
Dec 14, 2005
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1678 KS Primary

Addresses

Primary practice location

12621 Antioch Rd
Overland Park, KS 66213-1701

Mailing address

12621 Antioch Rd
Overland Park, KS 66213-1701
Phone (913) 814-7707

Other identifiers 2

IdentifierTypeStateIssuer
35448021OtherMOKANSAS CITY BLUE CROSS
200331480AMedicaidKS

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
I20101209000373 KS Practitioner - Optometry 4486542768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Valley Eyecare, LLCGroup PAC ID 4981729175, 3 clinicians

Practice addresses (Care Compare)

12621 Antioch Rd
Overland Park, KS 66213-1701
Phone (913) 814-7707

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1678KSMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Valley Eyecare, LLC Optometrist CurrentSince Sep 21, 2010 Accepting new patients
DRS Hawks, Besler and Rogers Optometrist Past Accepting new patients
Hopping Eye Associates, LLP Optometrist PastSince Jan 1, 1990 Accepting new patients

Locations

12621 Antioch Rd
Overland Park, KS 66213
Phone (913) 814-7707

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.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1902881782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12621 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131701",
            "telephone_number": "913-814-7707",
            "fax_number": "913-814-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12621 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131701",
            "telephone_number": "913-814-7707",
            "fax_number": "913-814-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "MELISSA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS CITY BLUE CROSS",
            "identifier": "35448021",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200331480A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.