Individual provider Active NPI

Bradley Dale Cary, OD

  • Optometrist
  • Columbia, MO
National Provider Identifier
1114594892
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2021020081 Issued in MO
Practice address
3301 W Broadway Business Park CT Ste E
Columbia, MO 65203-0106
Phone
(573) 446-1600
NPI assigned
Jun 9, 2021
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2021020081 MO Primary

Addresses

Primary practice location

3301 W Broadway Business Park CT Ste E
Columbia, MO 65203-0106

Mailing address

3301 W Brdwy Bus Park CT
Ste E
Columbia, MO 65203-0106
Phone (573) 446-1600

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
I20210712000330 MO Practitioner - Optometry 9032511241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eldon Family Focus Eyecare LLCGroup PAC ID 9537496385, 4 clinicians
Columbia Family Focus Eyecare LLCGroup PAC ID 8921328436, 6 clinicians

Practice addresses (Care Compare)

115 N Oak St
Eldon, MO 65026-1444
Phone (573) 392-7126

725 S Scott Blvd
Suite 101
Columbia, MO 65203-0396
Phone (573) 446-1600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Family Focus Eyecare, LLC Optometrist CurrentSince Jul 5, 2021 Accepting new patients
Eldon Family Focus Eyecare LLC Optometrist CurrentSince Jul 5, 2021 Accepting new patients

Locations

3301 W Broadway Business Park Ct
Ste E
Columbia, MO 65203
Phone (573) 446-1600

725 S Scott Blvd
Ste 101
Columbia, MO 65203
Phone (573) 444-1600

115 N Oak St
Eldon, MO 65026
Phone (573) 392-7126

Organizations & group practices 2

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": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1114594892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W BRDWY BUS PARK CT",
            "address_2": "STE E",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652030106",
            "telephone_number": "573-446-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W BROADWAY BUSINESS PARK CT STE E",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652030106",
            "telephone_number": "573-446-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARY",
        "first_name": "BRADLEY",
        "middle_name": "DALE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2021020081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.