BROADWAY VISION SOURCE, INCORPORATED
NPI 1710456249
Optometrist in Eagle Grove, IA
About Broadway Vision Source, Incorporated NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROADWAY VISION SOURCE, INCORPORATED (NPI 1710456249) is a healthcare organization registered as an optometrist in Eagle Grove, Iowa and active in the NPI registry since November 2018. The organization lists Brandon S Hauck, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
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)
Broadway Vision Source, Incorporated is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 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
Medicare enrollment records show 1 clinician reassigns Medicare billing to Broadway Vision Source, Incorporated, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medical Equipment Supplier Medicare DMEPOS 2
Medicare supplier enrollment and the product categories Broadway Vision carries, from the Medicare DMEPOS supplier directory.
Broadway Vision
DMEPOS supplier · Eagle Grove, IAOperated by Broadway Vision Source, IncorporatedAccepts Medicare assignment
Broadway Vision agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Product Categories
Frequently 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 Broadway Vision Source, Incorporated's NPI number?
The NPI number for Broadway Vision Source, Incorporated is 1710456249. It was assigned to this organization in the NPPES registry on November 14, 2018.
Where is Broadway Vision Source, Incorporated located?
Broadway Vision Source, Incorporated is located at 300 W Broadway St, Eagle Grove, IA 50533. The listed phone number is (515) 448-3813.
What is Broadway Vision Source, Incorporated's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Broadway Vision Source, Incorporated enrolled in Medicare?
Yes. Broadway Vision Source, Incorporated is registered in the Medicare PECOS enrollment system.
When is Broadway Vision Source, Incorporated's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Iowa, Physician - Optometrist) is due for revalidation by March 31, 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 Broadway Vision Source, Incorporated?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Broadway Vision Source, Incorporated. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Broadway Vision Source, Incorporated accept Medicare assignment for medical equipment?
Yes. As a Medicare medical equipment supplier, Broadway Vision accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.
What insurance does Broadway Vision Source, Incorporated accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list Broadway Vision Source, Incorporated 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 Broadway Vision Source, Incorporated was last updated on November 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Broadway Vision Source, Incorporated · NPI 1710456249
Optometrist organization in Eagle Grove, Iowa. Organization record, active in the CMS NPPES registry since November 14, 2018.
## Identity
- **NPI:** 1710456249 (Entity type: Organization)
- **Enumerated:** November 14, 2018
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** Yes (part of Broadway Vision Source, Incorporated)
- **Authorized official:** Brandon Hauck, OWNER
## Practice location
- **Address:** 300 W BROADWAY ST, Eagle Grove, IA 50533-1712
- **Phone:** (515) 448-3813 · **Fax:** (515) 448-3885
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (DME, Iowa, Physician - Optometrist) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Optometry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 14, 2018
- **Other identifiers:** Medicaid 1346620432 (IA); Other 1346620432 (IA)
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Source: [NPI Profile](https://npiprofile.com/npi/1710456249) · Data from the CMS NPPES public registry.