Nicole Dyan Verachtert, O.D.
Individual provider Active NPI Optometrist · Parkville, MO
NPI 1073560108 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1073560108
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- T03469 (MO)
- Practice address
- 6325 Lewis Dr
Suite 114
Parkville, MO 64152-3699 - Phone
- (816) 505-0100
- Fax
- (816) 505-2301
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Viking Vision Inc
Nass, Inc
Practice addresses (Care Compare)
5769 NE Antioch Rd
In Vision Eye Care Center Gladstone
Gladstone, MO 64119-2017
Phone (816) 454-3937
6325 Lewis Dr
Suite 114
Parkville, MO 64152-4505
Phone (816) 505-0100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 38 |
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 |
|---|---|---|---|---|
| I20040901001390 | MO | Practitioner - Optometry | 5597730424 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T03469 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nass, Inc | Optometrist | Current |
Accepting new patients |
Locations
6325 Lewis Dr
Ste 114
Parkville, MO 64152
Phone (816) 505-0100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T03469 | MO | Yes |
Addresses
Primary practice location
6325 Lewis Dr
Suite 114
Parkville, MO 64152-3699
Mailing address
6420 NW Forest CT
Parkville, MO 64152-3139
Phone (816) 880-0242
Other providers in Parkville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. 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.