Individual provider Active NPI

Michael Rohde, O.D.

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1023014024
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02739 Issued in MO
Practice address
2572 Lemay Ferry Rd
Saint Louis, MO 63125-3131
Phone
(314) 892-3321
Fax
(314) 845-9603
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02739 MO Primary

Addresses

Primary practice location

2572 Lemay Ferry Rd
Saint Louis, MO 63125-3131

Mailing address

40 E North St
Eureka, MO 63025-1205
Phone (636) 200-4393

Other identifiers 2

IdentifierTypeStateIssuer
410040187OtherMORAILROAD MEDICARE
312613516MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110304000771 MO Practitioner - Optometry 9335321884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry IncGroup PAC ID 0840411799, 82 clinicians

Practice addresses (Care Compare)

2572 Lemay Ferry Rd
Saint Louis, MO 63125-3131
Phone (314) 892-3321

3122 S Grand Blvd
The Spec Shoppe
St Louis, MO 63118-1012
Phone (314) 450-7313

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02739MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Inc Optometrist CurrentSince Aug 20, 2014 Accepting new patients
Clarkson Optometry, Inc Optometrist CurrentSince Aug 20, 2014 Accepting new patients
Clarkson Eyecare Optometrist Past Accepting new patients

Locations

3936 Vogel Rd
Arnold, MO 63010
Phone (636) 262-4982

330 W Osage St
Pacific, MO 63069
Phone (636) 271-4500

11433 Olive Blvd
Saint Louis, MO 63141
Phone (314) 432-1134

2572 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 892-3321

730 S Kirkwood Rd
Saint Louis, MO 63122
Phone (314) 569-2020

4305 Butler Hill Rd
Saint Louis, MO 63128
Phone (314) 487-4744

3122 S Grand Blvd
Saint Louis, MO 63118
Phone (314) 450-7313

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Interoperability endpoints

  • Direct secure messaging: michaelrohde@direct.eyecare-partners.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1023014024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E NORTH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-200-4393",
            "fax_number": "636-938-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2572 LEMAY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253131",
            "telephone_number": "314-892-3321",
            "fax_number": "314-845-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHDE",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410040187",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312613516",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.