Individual provider Active NPI

Alicia Genilo, OD

  • Optometrist
  • Lee's Summit, MO
National Provider Identifier
1962060293
Registry record updated Jun 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2019017140 Issued in MO
Practice address
3660 NE Ralph Powell Rd
Lees Summit, MO 64064-2357
Phone
(816) 524-7400
NPI assigned
Jun 1, 2019
Last updated
Jun 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2019017140 MO Primary

Addresses

Primary practice location

3660 NE Ralph Powell Rd
Lees Summit, MO 64064-2357

Mailing address

13120 King St
Overland Park, KS 66213-4483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190620003051 MO Practitioner - Optometry 8921332297 Reassigns benefits to 1 organization
I20190821000246 KS Practitioner - Optometry 8921332297 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paige Hedgpath OdpcGroup PAC ID 5991856460, 25 clinicians
Acuity Vision Center LLCGroup PAC ID 3971930728, 16 clinicians

Practice addresses (Care Compare)

1400 Forum Blvd
Suite 14
Columbia, MO 65203-1997
Phone (573) 446-0331

3660 NE Ralph Powell Rd
Lees Summit, MO 64064-2357
Phone (816) 524-7400

5820 Lamar Ave
Mission, KS 66202-2612
Phone (913) 432-7676

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paige Hedgpath Odpc Optometrist CurrentSince Dec 22, 2021 Accepting new patients
Acuity Vision Center LLC Optometrist CurrentSince Apr 25, 2024 Accepting new patients
Paige Hedgpath OD,PC Optometrist CurrentSince Dec 22, 2021 Accepting new patients
Insight Vision Center LLC Optometrist Past Accepting new patients
Brill Eye Center LLC Optometrist PastSince Sep 16, 2003 Accepting new patients

Locations

15601 W 87th Street Pkwy
Lenexa, KS 66219
Phone (913) 406-1809

5820 Lamar Ave
Mission, KS 66202
Phone (913) 432-7676

5820 Lamar Ave
Ste 100
Mission, KS 66202
Phone (913) 432-7676

11114 S Lone Elm Rd
Olathe, KS 66061
Phone (913) 390-6700

1400 Forum Blvd
Ste 14
Columbia, MO 65203
Phone (573) 446-0331

323 Monroe St
Jefferson Cty, MO 65101
Phone (573) 635-1313

3660 NE Ralph Powell Rd
Lees Summit, MO 64064
Phone (816) 524-7400

Interoperability endpoints

  • Direct secure messaging: agenilo@customeyeskc1.eyefinity-direct.com

Organizations & group practices 6

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": "1559347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559347200000",
    "number": "1962060293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13120 KING ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662134483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 NE RALPH POWELL RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642357",
            "telephone_number": "816-524-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENILO",
        "first_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-01",
        "last_updated": "2019-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2019017140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.