Provider Demographics
NPI:1407988009
Name:IOWA EYECARE ASSOCIATES PC
Entity Type:Organization
Organization Name:IOWA EYECARE ASSOCIATES PC
Other - Org Name:THE EYECARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF THE BOARD
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOEKE
Authorized Official - Suffix:
Authorized Official - Credentials:OPTOMETRIST
Authorized Official - Phone:319-236-0815
Mailing Address - Street 1:999 HOME PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-4822
Mailing Address - Country:US
Mailing Address - Phone:319-236-0815
Mailing Address - Fax:319-234-0847
Practice Address - Street 1:516 DIVISION ST
Practice Address - Street 2:SUITE 120
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2382
Practice Address - Country:US
Practice Address - Phone:319-266-0345
Practice Address - Fax:319-268-1327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0117267Medicaid
IA18418OtherBLUE CROSS BLUE SHIELD
IAT00871Medicare UPIN
IAT93064Medicare UPIN
IAT01141Medicare UPIN
IAT01113Medicare UPIN
IA410026798Medicare PIN
IA18418OtherBLUE CROSS BLUE SHIELD
IA410027324Medicare PIN
IA0117267Medicaid
IA410023574Medicare PIN
IA18418Medicare PIN
IAT88477Medicare UPIN
IA0358460001Medicare NSC
IACG4244Medicare PIN