Eli B Lemonier, O.D.
Individual provider Active NPI Optometrist · Springfield, MO
NPI 1013105022 · NPPES record last updated Jan 5, 2024
Key facts
- NPI
- 1013105022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2014001815 (MO)
- Practice address
- 1724 W Kearney St Ste 116
Springfield, MO 65803-1692 - Phone
- (417) 865-4448
- Fax
- (417) 862-8704
- NPI assigned
- Oct 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1724 W Kearney St
Suite 116
Springfield, MO 65803-1692
Phone (417) 865-4448
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 |
|---|---|---|---|---|
| I20140516001421 | MO | Practitioner - Optometry | 3779733753 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 774 | MS | MD | Chiropractor |
Practice roles (2 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Family Eye Care Inc | Optometrist | Current |
Accepting new patients |
| Riverbend Healthcare PLLC | Past |
Accepting new patients |
Locations
1724 W Kearney St
Ste 116
Springfield, MO 65803
Phone (417) 865-4448
1724 W Kearney St
Springfield, MO 65803
Networks
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- IA HMO C-SNP
- IA HMO
- IL PPO Downstate
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
Interoperability endpoints
- https://api.platform.athenahealth.com/24012/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2014001815 | MO | Yes |
Addresses
Primary practice location
1724 W Kearney St Ste 116
Springfield, MO 65803-1692
Mailing address
1724 W Kearney St Ste 116
Springfield, MO 65803-1692
Phone (417) 865-4448
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12035182 | Other | CAQH |
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2024. 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.