NPIMap

Organization Active NPI

Ophthalmology Consultants, LLC

Doing business as Ophthalmology Associates

  • Ophthalmology Physician
  • Saint Louis, MO
National Provider Identifier
1003960980
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
R1E17 Issued in MO
Legal business name
OPHTHALMOLOGY CONSULTANTS, LLC
Doing business as
Ophthalmology Associates
Practice address
12990 Manchester Rd
Suite 200
Saint Louis, MO 63131-1860
Phone
(314) 966-5000
Fax
(314) 909-6666
NPI assigned
Jan 22, 2007
Last updated
Dec 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph Pravoot GiraNPI 1861481152
Title
Cmo
Phone
(314) 909-0633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X R1E17 MO Primary

Addresses

Primary practice location

12990 Manchester Rd
Suite 200
Saint Louis, MO 63131-1860

Mailing address

12990 Manchester Rd
Suite 200
Saint Louis, MO 63131-1860
Phone (314) 966-5000

Other names 1

  • Ophthalmology Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505001055 MO Part B Supplier - Clinic/Group Practice 6800884008 Receives reassigned benefits from 24 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: O Fallon, MO; Washington, MO; Union, MO; Troy, MO; Sullivan, MO; Saint Louis, MO; Saint Charles, MO; Lake St Louis, MO…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1022370Ophthalmology Associates12990 Manchester Road, Ste 200, Saint Louis, MO 63131Certificate of waiverNov 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Ophthalmology Consultants LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

12990 Manchester Rd
Ste 20
Saint Louis, MO 63131
Phone (314) 966-5000

1325 Queens Ct
Saint Peters, MO 63376
Phone (636) 441-8010

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1003960980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12990 MANCHESTER RD",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311860",
            "telephone_number": "314-966-5000",
            "fax_number": "314-909-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12990 MANCHESTER RD",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311860",
            "telephone_number": "314-966-5000",
            "fax_number": "314-909-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMOLOGY CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "GIRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PRAVOOT",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "314-909-0633"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "R1E17",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ophthalmology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ophthalmology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.