Thebe Bagwasi

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

2004003244 Issued in MO

Practice address

2100 Collier Corporate Pkwy
Saint Charles, MO 63303-6708

Phone

(636) 410-8285

Fax

(636) 410-8397

NPI assigned

Aug 5, 2006

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 MO, IL2 enrollments

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 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Missouri Vision Care

  • Corneal and Contact Management Optometrist
  • Saint Charles, MO
  • NPI 1720783830
  Medicare reassignment NPD Authorized official
• Charles S Ovitsky PC

  • Optometrist
  • Chicago, IL
  • NPI 1568647220
  Medicare reassignment NPD

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1124037320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 COLLIER CORPORATE PKWY",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036708",
            "telephone_number": "636-410-8285",
            "fax_number": "636-410-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 COLLIER CORPORATE PKWY",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036708",
            "telephone_number": "636-410-8285",
            "fax_number": "636-410-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWASI",
        "first_name": "THEBE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MO",
            "license": "2004003244",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046009635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Azzam, CRNA
• Babar Enterprises LLC
• Tammy Jean Bader, RNFA
• Amanda Baebler
• Kelly Baerveldt, DPT
• Johnathan Bailey-Smith, LMSW
• Laura Lynn Bailey
• Cory Baker
• Doyne Baker, LCSW
• Karlee Baker

• Corneal and Contact Management Optometrist in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Corneal and Contact Management Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.