FAYETTEVILLE EYECARE CLINIC
NPI 1588999767
Optometrist in Fayetteville, AR
About Fayetteville Eyecare Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAYETTEVILLE EYECARE CLINIC (NPI 1588999767) is a healthcare organization registered as an optometrist in Fayetteville, Arkansas and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through January 5, 2028 and lists Tasker N Rodman, Managing Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fayetteville Eyecare Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Fayetteville Eyecare Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 04D2002024
Fayetteville Eyecare Clinic · Fayetteville, ARFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Fayetteville Eyecare Clinic's NPI number?
The NPI number for Fayetteville Eyecare Clinic is 1588999767. It was assigned to this organization in the NPPES registry on October 6, 2009.
Where is Fayetteville Eyecare Clinic located?
Fayetteville Eyecare Clinic is located at 1915 N Green Acres Rd, Fayetteville, AR 72703. The listed phone number is (479) 442-8961.
What is Fayetteville Eyecare Clinic's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Fayetteville Eyecare Clinic enrolled in Medicare?
Yes. Fayetteville Eyecare Clinic is registered in the Medicare PECOS enrollment system.
When is Fayetteville Eyecare Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Fayetteville Eyecare Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Fayetteville Eyecare Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Fayetteville Eyecare Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2002024) is associated with this NPI, valid through January 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Fayetteville Eyecare Clinic accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 7 other insurers list Fayetteville Eyecare Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Fayetteville Eyecare Clinic was last updated on June 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Fayetteville Eyecare Clinic · NPI 1588999767
Optometrist organization in Fayetteville, Arkansas. Organization record, active in the CMS NPPES registry since October 6, 2009.
## Identity
- **NPI:** 1588999767 (Entity type: Organization)
- **Enumerated:** October 6, 2009
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Tasker Rodman, MANAGING PARTNER
## Practice location
- **Address:** 1915 N GREEN ACRES RD, Fayetteville, AR 72703-2617
- **Phone:** (479) 442-8961 · **Fax:** (479) 442-6440
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Arkansas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 24, 2020
- **Other identifiers:** Medicaid 182431722 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1588999767) · Data from the CMS NPPES public registry.