Individual provider Active NPI

Larry F Pratt, O.D.

  • Optometrist
  • Aurora, MO
National Provider Identifier
1033248901
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02302 Issued in MO
Practice address
930 S Elliott Ave
Aurora, MO 65605-2402
Phone
(417) 678-2161
Fax
(417) 678-2241
NPI assigned
Mar 5, 2007
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02302 MO Primary

Addresses

Primary practice location

930 S Elliott Ave
Aurora, MO 65605-2402

Mailing address

PO Box 676
Aurora, MO 65605-0676
Phone (417) 678-2161

Other identifiers 1

IdentifierTypeStateIssuer
310574918MedicaidMO

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
I20110325000730 MO Practitioner - Optometry 9133238082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

930 S Elliott Ave
Aurora, MO 65605-2402
Phone (417) 678-2161

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Huntress Visionhealth Associates LLC Optometrist PastSince Jun 3, 2013 Accepting new patients

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • IA HMO

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1033248901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 676",
            "city": "AURORA",
            "state": "MO",
            "postal_code": "656050676",
            "telephone_number": "417-678-2161",
            "fax_number": "417-678-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S ELLIOTT AVE",
            "city": "AURORA",
            "state": "MO",
            "postal_code": "656052402",
            "telephone_number": "417-678-2161",
            "fax_number": "417-678-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "LARRY",
        "middle_name": "F",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310574918",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, MO

Sources for this page

Verify at the official NPI Registry.