Mary K Lueckenhoff, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02959 Issued in MO

Practice address

1 Barnes Jewish Hospital PLZ
Div Optometry, 1St FL
Saint Louis, MO 63110-1003

Phone

(314) 362-6123

Fax

(314) 747-3726

NPI assigned

Jul 14, 2006

Sex

Female

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

Other names 1

• Mary K Migneco Former name

Electronic endpoints 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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seibert Mobile Optometry LLCGroup PAC ID 7517242746, 9 clinicians

Overland Optical, Inc.Group PAC ID 4284616814, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.93 of 100Reported as group

Quality

76.24

Promoting interoperability

100

Improvement activities

40

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 and National Provider Directory roles.

• Overland Optical, Inc.

  • Optician
  • Saint Louis, MO
  • NPI 1457377848

  MO

  Medicare reassignment Care Compare group NPD
• Seibert Mobile Optometry LLC

  • Optometrist
  • Jefferson City, MO
  • NPI 1679017362

  MO, Optometrist

  Medicare reassignment Care Compare group NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1013957562

  MO

  Medicare reassignment NPD
• Overland Optical, Inc

  • Optician
  • Saint Charles, MO
  • NPI 1396833174
  Care Compare group NPD (past)
• Washington University

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
  • NPI 1841221116
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1134169568
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1104842335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8096",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-3937",
            "fax_number": "314-747-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DIV OPTOMETRY, 1ST FL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-6123",
            "fax_number": "314-747-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUECKENHOFF",
        "first_name": "MARY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313588709",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Div Optometry, 1st Fl",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MIGNECO",
            "middle_name": "K",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Lynn Luebbert, M.A., CCC-SLP
• Rebecca A. Luebbert, MSN, APRN, BC
• Debra A Luechtefeld, PSY.D.
• Matthew Luechtefeld
• Linda Luecke, LPC
• Maxine Lueckenotte, FNP
• Jessica Luedde, FSP
• Joel Gary Luedeke, D.M.D.
• Gregg T Lueder, MD
• Susan L Luedke, M.D.

• All providers in Saint Louis, MO
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.