Provider Demographics
NPI:1619937133
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
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:OD
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 1:999 HOME PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-4822
Practice Address - Country:US
Practice Address - Phone:319-236-0815
Practice Address - Fax:319-234-0847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA18418OtherWELLMARK BLUE CROSS BLUE
IA0117267Medicaid
IACG4244OtherMEDICARE ID
IA0358460003Medicare NSC
IA18418Medicare PIN
IAT00871Medicare UPIN
IAT01113Medicare UPIN
IACG4244OtherMEDICARE ID
IAT93064Medicare UPIN
IAT01141Medicare UPIN