Individual provider Active NPI

Scott A. Tomasino, O.D.

  • Optometrist
  • O'Fallon, MO
National Provider Identifier
1124024906
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02664 Issued in MO
Practice address
302 E Pitman St
O Fallon, MO 63366-2623
Phone
(636) 272-1444
Fax
(636) 272-1359
NPI assigned
Jun 24, 2005
Last updated
Jul 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02664 MO Primary

Addresses

Primary practice location

302 E Pitman St
O Fallon, MO 63366-2623

Mailing address

302 E Pitman St
O Fallon, MO 63366-2623
Phone (636) 272-1444

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
I20100908000021 MO Practitioner - Optometry 5395813281 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02664MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Iverson-Tomasino Eyecare Inc Optometrist CurrentSince Nov 1, 1999 Accepting new patients
Ophthalmology Consultants, LLC Past Accepting new patients

Locations

1140 Tom Ginnever Ave
O Fallon, MO 63366
Phone (636) 272-1444

302 E Pitman St
O Fallon, MO 63366
Phone (636) 272-1444

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1124024906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 E PITMAN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662623",
            "telephone_number": "636-272-1444",
            "fax_number": "636-272-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E PITMAN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662623",
            "telephone_number": "636-272-1444",
            "fax_number": "636-272-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASINO",
        "first_name": "SCOTT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.