Individual provider Active NPI

Jeffrey M Gamble, OD

  • Optometrist
  • Columbia, MO
National Provider Identifier
1033164603
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2002015315 Issued in MO
Practice address
500 Keene St
Suite 103
Columbia, MO 65201-8104
Phone
(573) 874-2030
Fax
(573) 449-0253
NPI assigned
May 23, 2006
Last updated
Jun 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2002015315 MO Primary

Addresses

Primary practice location

500 Keene St
Suite 103
Columbia, MO 65201-8104

Mailing address

500 Keene St
Suite 103
Columbia, MO 65201-8104
Phone (573) 874-2030

Other identifiers 5

IdentifierTypeStateIssuer
P00221762OtherMORAILROAD MEDICARE
P00401206OtherMORAILROAD MEDICARE
176950OtherMOBC/BS
0270770001OtherMONORIDIAN-DMERC
315958306MedicaidMO

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
I20070712000384 MO Practitioner - Optometry 5193825644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Eye Consultants OptometryGroup PAC ID 2769574714, 14 clinicians

Practice addresses (Care Compare)

500 N Keene St
Suite 103
Columbia, MO 65201-8104
Phone (573) 874-2030

Merit-based Incentive Payment System (MIPS)

Final score
91.71 of 100Reported as group
Quality
95.95
Improvement activities
40
Cost
77.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2002015315MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Eye Consultants Optometry Optometrist CurrentSince Jul 16, 2002 Accepting new patients
Columbia Eyewear Past Accepting new patients

Locations

500 N Keene St
Ste 103
Columbia, MO 65201
Phone (573) 874-2030

Networks

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

Interoperability endpoints

  • Direct secure messaging: jeff.gamble@direct.revolutionehr.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1033164603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KEENE ST",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018104",
            "telephone_number": "573-874-2030",
            "fax_number": "573-449-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 KEENE ST",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018104",
            "telephone_number": "573-874-2030",
            "fax_number": "573-449-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2002015315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00221762",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00401206",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "176950",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN-DMERC",
            "identifier": "0270770001",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315958306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.