Stephen D. Bollinger, O.D.
Individual provider Active NPI Optometrist · O Fallon, MO
NPI 1003296120 · NPPES record last updated Mar 13, 2023
Key facts
- NPI
- 1003296120
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2015015577 (MO)
- Practice address
- 2946 Highway K
O Fallon, MO 63368-7861 - Phone
- (636) 240-1516
- NPI assigned
- Jun 3, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clarkson Optometry Inc
Practice addresses (Care Compare)
3122 S Grand Blvd
The Spec Shoppe
St Louis, MO 63118-1012
Phone (314) 450-7313
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150820010602 | MO | Practitioner - Optometry | 3072828987 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015015577 | MO | MD | Optometrist |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarkson Eyecare | Optometrist | Past | Accepting new patients |
Networks
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- IL PPO Downstate
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
Interoperability endpoints
- stephenbollinger@direct.eyecare-partners.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2015015577 | MO | Yes |
Addresses
Primary practice location
2946 Highway K
O Fallon, MO 63368-7861
Mailing address
514 Warren County Ctr
Warrenton, MO 63383-3023
Phone (636) 377-2054
Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.