Kevin Jacob Dittlinger, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2018021087 Issued in MO

Practice address

7840 Natural Bridge Blvd
Patient Care Center
Saint Louis, MO 63121

Phone

(314) 516-5131

Fax

(314) 516-5507

NPI assigned

Jun 20, 2018

Last updated

Feb 27, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Eye Care LLCGroup PAC ID 7416265194, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

60 of 100Reported as group

Quality

20

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Northwest Eye Care LLC

  dba Northwest Eye Care Professionals

  • Optometrist
  • Clackamas, OR
  • NPI 1669856902
  Medicare reassignment Care Compare group NPD
• Curators of the University of Missouri

  dba Center for Eye Care

  • Optometrist
  • Saint Louis, MO
  • NPI 1679664718
  NPD
• Curators of the University of Missouri

  dba Mizzou Pharmacy - Southwest Blvd

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1740083641
  NPD
• Curators of the University of Missouri

  dba Center for Eye Care

  • Optometrist
  • Saint Louis, MO
  • NPI 1922190198
  NPD
• Bruce R Wojciechowski

  dba Northwest Eye Care Professionals

  • Optometrist
  • Clackamas, OR
  • NPI 1699976530
  NPD (past)

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1114411451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY BLVD",
            "address_2": "PATIENT CARE CENTER",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63121",
            "telephone_number": "314-516-5131",
            "fax_number": "314-516-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 NATURAL BRIDGE BLVD",
            "address_2": "PATIENT CARE CENTER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63121",
            "telephone_number": "314-516-5131",
            "fax_number": "314-516-5507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3940 Lindell Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631083204",
            "country_code": "US",
            "telephone_number": "314-516-5016",
            "fax_number": "314-535-4741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITTLINGER",
        "first_name": "KEVIN",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2018021087",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MO",
            "license": "2018021087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Distinct Home Health LLC
• Distinguished Healthcare LLC
• Madeline Jane Distler, ACNP
• Sarah Marie Ditch, MD
• Diane E Dito, ANP
• Larina Jolynn Ditto, MSW
• Nicole Niara Ditto
• Vijayalakshmi Divakaran, ARNP, BC
• Richard M Divalerio, M.D.
• Divan Chiropractic and Sports Rehabilitation

• Optometrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.