Edward M Penick III, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

E-4798 Issued in AR

Practice address

5300 W Markham St
Little Rock, AR 72205-3528

Phone

(501) 664-5354

Fax

(501) 664-5257

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Arkansas College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Arkansas OphthalmologyGroup PAC ID 1850447632, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Arkansas Ophthalmology

  • Ophthalmology Physician
  • Little Rock, AR
  • NPI 1396809679
  Medicare reassignment Care Compare group NPD
• Blandford Eyecare & Surgery

  • Ophthalmology Physician
  • Little Rock, AR
  • NPI 1992714521
  NPD
• Deer Optical

  • Eyewear Supplier
  • Little Rock, AR
  • NPI 1437471588
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1962449892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053528",
            "telephone_number": "501-664-5354",
            "fax_number": "501-664-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053528",
            "telephone_number": "501-664-5354",
            "fax_number": "501-664-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENICK",
        "first_name": "EDWARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "E-4798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00337243",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160765001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joy R. Pemberton, PH.D.
• Jacquelyn Michelle Pena, M.D
• Victoria Alexandra Pena
• Denise Q Pendergist
• Penick Eye Center
• Alice Kristine Penn, NP
• James A Penney III, D.D.S.
• Gabrielle Marie Pennington, SLP
• Jaymie H Pennington, MD
• Taylor McKenzie Pennington, LAC

• Ophthalmology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Ophthalmology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.