Individual provider Active NPI

Stacy Becvar, O.D.

  • Optometrist
  • Columbia, MO
National Provider Identifier
1104844414
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2004021756 Issued in MO
Practice address
1109 Club Village Dr
Suite 106
Columbia, MO 65203-4466
Phone
(573) 441-2020
NPI assigned
Jul 17, 2006
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2004021756 MO Primary

Addresses

Primary practice location

1109 Club Village Dr
Suite 106
Columbia, MO 65203-4466

Mailing address

3405 Kunlun Dr
Columbia, MO 65203-8012

Other identifiers 1

IdentifierTypeStateIssuer
317214906MedicaidMO

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
I20050519000037 MO Practitioner - Optometry 1951205624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Becvar Optometry, LLCGroup PAC ID 8921049016, 2 clinicians

Practice addresses (Care Compare)

823 Eastland Plaza
Jefferson City, MO 65101-3893
Phone (573) 893-4223

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Becvar Optometry, LLC CurrentSince Apr 20, 2005 Accepting new patients

Locations

1109 Club Village Dr
Ste 106
Columbia, MO 65203
Phone (573) 441-2020

823 Eastland Dr
Jefferson Cty, MO 65101
Phone (573) 893-4223

Organizations & group practices 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1104844414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 KUNLUN DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652038012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 CLUB VILLAGE DR",
            "address_2": "SUITE 106",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034466",
            "telephone_number": "573-441-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECVAR",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2004021756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317214906",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.