David Paul Prange, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO3447 Issued in MO

Practice address

16978 Manchester Rd
Wildwood, MO 63040-1200

Phone

(636) 273-6336

Fax

(636) 273-9172

NPI assigned

Jun 8, 2006

Last updated

Aug 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cherry Hills Family Eye Care, L.L.C.Group PAC ID 7315959210, 4 clinicians

Prange Riley Optometrists PCGroup PAC ID 2264413814, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cherry Hills Family Eye Care, L.L.C.

  • Optometrist
  • Wildwood, MO
  • NPI 1992742498
  Medicare reassignment Care Compare group Authorized official
• Prange Riley Optometrists, P.C.

  dba Sullivan Eye Care

  • Optometrist
  • Sullivan, MO
  • NPI 1316072986
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1053352559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16978 MANCHESTER RD",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401200",
            "telephone_number": "636-273-6336",
            "fax_number": "636-273-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16978 MANCHESTER RD",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401200",
            "telephone_number": "636-273-6336",
            "fax_number": "636-273-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANGE",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318816204",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Elizabeth Ottinger, MSW, LCSW
• Komal J Patel, RD
• Judy A Plank
• Jerod Anthony Posey, DC
• Eric W Poynter, R.PH
• Anika Pulumati
• Rachel Marie Qualley, M.D.
• Katherine Reckelhoff, D.C.
• Kurtis Reitz, DDS
• Restore Movement Physical Therapy

• Optometrist in Wildwood, MO
• Providers in Wildwood, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.