Provider Type Icon

DESOTO EYECARE INC NPI 1376576884


NPI Information

NPI: 1376576884
Provider Name: DESOTO EYECARE INC
Classification: Exclusive Provider Organization - 302F00000X
Entity Type: Organization

CLIA Number: 25D1098836

Address:
726 GOODMAN RD E STE B
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 349-1959
Get Directions

DESOTO EYECARE INC is an exclusive provider organization in Southaven, MS. The provider is (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. DESOTO EYECARE INC NPI is 1376576884. The provider is registered as an organization entity type.

The provider's business location address is:

726 GOODMAN RD E STE B
SOUTHAVEN, MS
ZIP 38671-530
Phone: (662) 349-1959
Fax: (662) 349-0424

The provider's authorized official is Alan R Schaeffer .
The authorized official title is Md Owner and has the following contact phone number (662) 349-1959.

The CLIA number assigned to this NPI record is 25D1098836 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 9/19/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1302F00000XExclusive Provider Organization14992MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1V07496MEDICARE UPINMISSISSIPPI
23723748MEDICARE PINTENNESSEE
3A13768MEDICARE UPINMISSISSIPPI
44245630001MEDICARE NSCMISSISSIPPI
5180000264MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.