Individual provider Active NPI

Buffie Jane Mock, O.D.

  • Optometrist
  • Overland Park, KS
National Provider Identifier
1992776793
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1577 Issued in KS
Practice address
11500 W 119TH St
Overland Park, KS 66213-2002
Phone
(913) 451-0001
Fax
(913) 451-1659
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1577 KS Primary

Addresses

Primary practice location

11500 W 119TH St
Overland Park, KS 66213-2002

Mailing address

5195 W 199TH St
Stilwell, KS 66085-9016
Phone (913) 239-8884

Other identifiers 1

IdentifierTypeStateIssuer
27308012OtherBLUE CROSS BLUE SHIELD

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
I20080827000308 KS Practitioner - Optometry 1557437555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burlingame and Mock Vision Associates, IncGroup PAC ID 0547336547, 5 clinicians

Practice addresses (Care Compare)

11500 W 119TH St
Overland Park, KS 66213-2002
Phone (913) 451-0001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burlingame & Mock Vision Associates, Inc Optometrist CurrentSince Jan 1, 2008 Accepting new patients
Professional Eyecare Management Inc. Optometrist Past Accepting new patients

Locations

11500 W 119th St
Overland Park, KS 66213
Phone (913) 451-0001

11806 Quivira Rd
Overland Park, KS 66210
Phone (913) 451-0001

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1992776793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5195 W 199TH ST",
            "city": "STILWELL",
            "state": "KS",
            "postal_code": "660859016",
            "telephone_number": "913-239-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132002",
            "telephone_number": "913-451-0001",
            "fax_number": "913-451-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "BUFFIE",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "27308012",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.