Randall Nacke, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

TP10024907 Issued in TX

Practice address

1400 Hwy 61 South
Suite 130
Crystal City, MO 63019

Phone

(636) 937-8855

Fax

(636) 931-6561

NPI assigned

Aug 16, 2006

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

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Iowa, RJ & L Carver College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premiere Eye Associates, P.C.Group PAC ID 5991741274, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.22 of 100Reported as group

Quality

92.6

Promoting interoperability

96

Improvement activities

40

Cost

74.78

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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.

• Premiere Eye Associates, P.C.

  dba InSight Optical

  • Ophthalmology Physician
  • Crystal City, MO
  • NPI 1740201482
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1093828782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "63019",
            "telephone_number": "636-937-8855",
            "fax_number": "636-931-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HWY 61 SOUTH",
            "address_2": "SUITE 130",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "63019",
            "telephone_number": "636-937-8855",
            "fax_number": "636-931-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACKE",
        "first_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "TP10024907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camran Mehrsheikh
• Meramec Emergency Physicians, LLP
• Mercy Labs Jefferson, LLC
• John Irving Mills, DDS
• Missouri CVS Pharmacy LLC (CVS Pharmacy # 10025)
• Geoffrey Edward Nelle, PT
• Nikodem Dental Holdings, Inc. (Nikodem Dental-Right Dental Care)
• Northland Hearing Center, Inc. (Southwestern Hearing Center)
• Ronald Wayne Parkin, D.M.D.
• Mitchell Scott Pearson

• Ophthalmology Physician in Crystal City, MO
• Providers in Crystal City, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.