NPIMap

Organization Active NPI

Willcockson Eye Associates, P.C.

  • Ophthalmology Physician
  • Yankton, SD
National Provider Identifier
1992802920
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0017 Issued in SD
Legal business name
WILLCOCKSON EYE ASSOCIATES, P.C.
Practice address
415 W 3Rd St
Yankton, SD 57078-4201
Phone
(605) 665-9638
Fax
(605) 665-0526
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Authorized official

Name
Mr. Lee Alan Gass
Title
Administrator
Phone
(605) 665-9638

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X SD
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 0017 SD Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

415 W 3Rd St
Yankton, SD 57078-4201

Mailing address

415 W 3Rd St
Yankton, SD 57078-4201
Phone (605) 665-9638

Other identifiers 1

IdentifierTypeStateIssuer
0000121OtherSDSD BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041008001120 SD Part B Supplier - Clinic/Group Practice 8729047295 Receives reassigned benefits from 3 practitioners
Practice locations: Yankton, SD
O20080820000378 NE Part B Supplier - Clinic/Group Practice 8729047295 Receives reassigned benefits from 3 practitioners
Practice locations: Creighton, NE; Hartington, NE; Norfolk, NE

National Provider Directory

National Provider Directory

Locations

415 W 3rd St
Yankton, SD 57078
Phone (605) 665-0938

Interoperability endpoints

  • Direct secure messaging: lrockne@willeye.intellechartdirect.net
  • Direct secure messaging: gkouri@willeye.intellechartdirect.net
  • Direct secure messaging: tkindle@willeye.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 6

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1992802920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W 3RD ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784201",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W 3RD ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784201",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLCOCKSON EYE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "GASS",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-665-9638",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "SD",
            "license": "0017",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD BLUE SHIELD",
            "identifier": "0000121",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.