Organization Active NPI

Premier Eyes

  • Optometrist
  • Brookfield, WI
National Provider Identifier
1932591682
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3010 Issued in WI
Legal business name
PREMIER EYES
Practice address
13965 W Burleigh Rd Ste 108
Brookfield, WI 53005-3074
Phone
(262) 505-5440
Fax
(262) 505-5414
NPI assigned
Mar 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Authorized official

Name
Dr. Bryan A Bell, ODNPI 1801874185
Title
Optometrist
Phone
(262) 505-5440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3010 WI Primary

Addresses

Primary practice location

13965 W Burleigh Rd Ste 108
Brookfield, WI 53005-3074

Mailing address

13965 W Burleigh Rd Ste 108
Brookfield, WI 53005-3074
Phone (262) 505-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150520000767 WI Part B Supplier - Clinic/Group Practice 0648590307 Receives reassigned benefits from 2 practitioners
Practice locations: Brookfield, WI
O20151125001934 WI DME Supplier - Physician - Optometrist 0648590307 Practice locations: Brookfield, WI

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Premier Eyes13965 W Burleigh Rd, Brookfield, WI 53005-3074(262) 505-5440 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since May 1, 2015

National Provider Directory

National Provider Directory

Locations

13965 W Burleigh Rd
Ste 108
Brookfield, WI 53005
Phone (262) 505-5440

7815 W Burleigh St
Milwaukee, WI 53222
Phone (414) 873-5135

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1932591682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13965 W BURLEIGH RD STE 108",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053074",
            "telephone_number": "262-505-5440",
            "fax_number": "262-505-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13965 W BURLEIGH RD STE 108",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053074",
            "telephone_number": "262-505-5440",
            "fax_number": "262-505-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-03",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "262-505-5440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.