DR. MAX STEVEN MANCILLAS (NPI# 1609827971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609827971 |
| Entity Type | Individual |
| Full Name | DR. MAX STEVEN MANCILLAS |
| Credential | O.D. |
| Practice Address |
11548 W 135th St Overland Park KS 66221-2892 |
| Mailing Address |
10556 Bluejacket St Overland Park KS 66214-3029 |
| Practice Telephone | 9138147600 |
| Practice Fax Number | 9138143906 |
| Mailing Telephone | 9134925417 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-10-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1225-3 | KS | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | STATE LICENSE NUMBER | 1225-3 | 01 |
| MO | STATE LICENSE | T2655 | 01 |
| DEA NUMBER | MM0345834 | 01 |
| Street Address |
11548 W 135TH ST |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66221-2892 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750936290 | Roling Chiropractic and Wellness LLC | Chiropractor | 11818 W 135th St, Overland Park, KS 66221 | 2019-08-01 |
| 1518519339 | Joshua Dale Roling | Chiropractor | 11818 West 135th Street, Overland Park, KS 66221 | 2019-07-11 |
| 1225508898 | Keaghan Michelle Shacklett | Specialist/Technologist | 13747 Cody St., Overland Park, KS 66221 | 2018-11-27 |
| 1215341003 | Creighton Gallagher, Dds LLC | Dentist | 8925 W 135th Street, Overland Park, KS 66221 | 2014-06-19 |
| 1508201963 | Jessica Mary Molstad | Nurse Practitioner | 11400 W. 135th Street, Overland Park, KS 66221 | 2013-04-29 |
| 1659687739 | Willie K Yuen | Physical Therapist | 11504 W 135th St., Performance Rehab. LLC, Overland Park, KS 66221 | 2010-08-26 |
| 1730414970 | Sue A. Klein | Physical Therapist | 11504 W. 135th St., Overland Park, KS 66221 | 2009-10-06 |
| 1538375407 | Michelle Tims | Occupational Therapist | 9101 158th St, Overland Park, KS 66221 | 2007-05-15 |
| 1124249321 | Choice of Health Pa | Chiropractor | 9120 W 135th Street, Suite 205, Overland Park, KS 66221 | 2007-05-02 |
| 1396830980 | Heartland Diabetic Supplies LLC | Non-Pharmacy Dispensing Site | 10703 W. 149th Street, Overland Park, KS 66221 | 2006-10-03 |
| Find all providers in zip 66221 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417495797 | Eye Associates of South Overland Park | Optometrist | 8029 W 159th St., Overland Park, KS 66223 | 2017-02-07 |
| 1356730766 | Blue Valley Vision of Overland Park LLC | Optometrist | 8007 W 151st St, Overland Park, KS 66223-2115 | 2015-01-22 |
| 1912328196 | Sukaromya Vision LLC | Optometrist | 9701 Metcalf Ave, Overland Park, KS 66212-2219 | 2013-12-14 |
| 1104264787 | Your Vision | Optometrist | 8641 W 135th St, Overland Park, KS 66223-1215 | 2013-06-05 |
| 1992954531 | Andrea Dawn Buchbaum | Optometrist | 10120 W. 119th Street, Overland Park, KS 66213-1600 | 2008-09-18 |
| 1649435710 | Gregor Eye Care, Pa | Optometrist | 15100 Metcalf Ave Ste 101, Overland Park, KS 66223-2899 | 2008-07-28 |
| 1164681409 | Four Eyes Optical, Lc | Optometrist | 11232 W 135th St, Overland Park, KS 66221-9800 | 2008-06-02 |
| 1649463621 | Jayme R Fose | Optometrist | 8007 W 151st St Ste 102, Overland Park, KS 66223 | 2007-08-22 |
| 1215133772 | Cynthia Yin, O.d., L.L.C. | Optometrist | 7127 W 95th St, Overland Park, KS 66212-2245 | 2007-06-22 |
| 1457486375 | Burlingame & Mock Vision Associates, Inc | Optometrist | 11500 W. 119th Street, Overland Park, KS 66213-2002 | 2007-02-22 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66221 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.