Southside Eyecare, Llc is a medicare enrolled "Eyewear Supplier" provider in Anchorage, Alaska. Their current practice location is
9350 Independence Dr, Anchorage, Alaska. You can reach out to their office (for appointments etc.) via phone at
(907) 561-1167.
Southside Eyecare, Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Southside Eyecare, Llc
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 1245403377.
Healthcare Provider's Profile
| Full Name | Southside Eyecare, Llc |
|---|
| Type | Facility |
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| Speciality | Eyewear Supplier |
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| Location | 9350 Independence Dr, Anchorage, Alaska |
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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: 1245403377
- Provider Enumeration Date: 04/09/2008
- Last Update Date: 12/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 7810888138
- Enrollment ID: O20040324000467
Medical Identifiers
Medical identifiers for Southside Eyecare, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245403377 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Southside Eyecare, Llc acts as a billing entity for following providers:
| Provider Name | Christie S Stemmle |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1265540058
PECOS PAC ID: 9537104526
Enrollment ID: I20050621000382 |
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| Provider Name | Jan H Nyboer |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1811005606
PECOS PAC ID: 2062303381
Enrollment ID: I20120328000520 |
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| Provider Name | Jacquelyn Anino Lamigo |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1568956563
PECOS PAC ID: 4880932557
Enrollment ID: I20200617000761 |
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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. Southside Eyecare, Llc 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 |
|---|
Southside Eyecare, Llc
9350 Independence Dr,
Anchorage, AK 99507-4613
Ph: (907) 561-1167 | Southside Eyecare, Llc
9350 Independence Dr,
Anchorage, AK 99507-4613
Ph: (907) 561-1167 |
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