Eyes On Broadway is a medicare enrolled "Optometrist" provider in Mayville, North Dakota. Their current practice location is
32 Main St W, Mayville, North Dakota. You can reach out to their office (for appointments etc.) via phone at
(701) 786-2666.
Eyes On Broadway is licensed to practice in North Dakota (license number 575) and it also participates in the medicare program. Eyes On Broadway
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1609062272.
Healthcare Provider's Profile
| Full Name | Eyes On Broadway |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 32 Main St W, Mayville, North Dakota |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1609062272
- Provider Enumeration Date: 09/18/2007
- Last Update Date: 03/18/2021
Medicare PECOS Information:
- PECOS PAC ID: 9830156280
- Enrollment ID: O20041216000825
Medical Identifiers
Medical identifiers for Eyes On Broadway such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609062272 | NPI | - | NPPES |
| 60602 | Medicaid | ND | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 575 (North Dakota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Eyes On Broadway acts as a billing entity for following providers:
| Provider Name | Michael K Rexine |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1700899143
PECOS PAC ID: 3971560327
Enrollment ID: I20041220000307 |
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| Provider Name | Vanessa R Manlove |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1376194472
PECOS PAC ID: 1951735125
Enrollment ID: I20191220001079 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Eyes On Broadway is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Eyes On Broadway
32 Main St W,
Mayville, ND 58257-1314
Ph: (701) 786-2666 | Eyes On Broadway
32 Main St W,
Mayville, ND 58257-1314
Ph: (701) 786-2666 |
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