Organization Active NPI

Eyecare Partners, P.C.

Doing business as Penn Central Eye Clinic

  • Optometrist
  • Oskaloosa, IA
National Provider Identifier
1942265467
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE PARTNERS, P.C.
Doing business as
Penn Central Eye Clinic
Practice address
200 High Ave W
Oskaloosa, IA 52577-2753
Phone
(641) 673-9263
NPI assigned
Apr 18, 2006
Last updated
Dec 13, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
EYECARE PARTNERS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Authorized official

Name
Ralph Dehaan, O.D.NPI 1790763811
Title
President
Phone
(641) 628-9225

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

200 High Ave W
Oskaloosa, IA 52577-2753

Mailing address

200 High Ave W
Oskaloosa, IA 52577-2753
Phone (641) 673-9263

Other identifiers 1

IdentifierTypeStateIssuer
0169862MedicaidIA

Other names 1

  • Penn Central Eye Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319000956 IA Part B Supplier - Clinic/Group Practice 0749170850 Receives reassigned benefits from 7 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Des Moines, IA; Pella, IA; West Des Moines, IA; Ames, IA

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Part of
Eyecar Partners PC

Practitioners & affiliated clinicians

Practitioners 6

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": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1942265467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH AVE W",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525772753",
            "telephone_number": "641-673-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH AVE W",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525772753",
            "telephone_number": "641-673-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PARTNERS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYECARE PARTNERS, P.C.",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "DEHAAN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-628-9225",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0169862",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Central Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oskaloosa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.