Active NPI
Todd Nitchman, O.D.
- Optometrist
- Saint Robert, MO
National Provider Identifier
1144235599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2001018906
- Practice address
- 185 St Robert Blvd
Saint Robert, MO 65584-3311 - Phone
- (573) 336-7407
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2001018906 | MO | Primary |
Addresses
Primary practice location
185 St Robert Blvd
Saint Robert, MO 65584-3311
Mailing address
21050 Rowden LN
Waynesville, MO 65583-2711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 317230308 | Medicaid | MO |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070702000189 | MO | Practitioner - Optometry | 7416056593 | Practice locations: St Robert, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
185 Saint Robert Blvd
Saint Robert, MO 65584-3311
Phone (573) 336-7407
185 St Robert Blvd
Saint Robert, MO 65584-3311
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001018906 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1144235599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21050 ROWDEN LN",
"city": "WAYNESVILLE",
"state": "MO",
"postal_code": "655832711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 ST ROBERT BLVD",
"city": "SAINT ROBERT",
"state": "MO",
"postal_code": "655843311",
"telephone_number": "573-336-7407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NITCHMAN",
"first_name": "TODD",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2001018906",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "317230308",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Robert, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; 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.