Individual provider Active NPI

Amy Brooke Mackey Carenza, OD

  • Optometrist
  • Maryland Heights, MO
National Provider Identifier
1174183529
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2019020522 Issued in MO
Practice address
2311 McKelvey Rd
Maryland Heights, MO 63043-1531
Phone
(314) 434-9450
NPI assigned
Jun 18, 2019
Last updated
Dec 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2019020522 MO Primary

Addresses

Primary practice location

2311 McKelvey Rd
Maryland Heights, MO 63043-1531

Mailing address

100 Piper Hill Dr Ste D
Saint Peters, MO 63376-1616
Phone (256) 997-7058

Other practice location 1

100 Piper Hill Dr
Saint Peters, MO 63376-1616
Phone (636) 928-3937

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
I20190826000676 MO Practitioner - Optometry 9032447362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appelman Eye Associates, LLCGroup PAC ID 7416040514, 2 clinicians

Practice addresses (Care Compare)

100 Piper Hill Dr
D
Saint Peters, MO 63376-1616
Phone (636) 928-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019020522MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Browning Corrections Optometry LLC CurrentSince Aug 1, 2019 Accepting new patients
Appelman Eye Associates, LLC Optometrist CurrentSince Jul 18, 2019 Accepting new patients

Locations

2311 McKelvey Rd
Maryland Heights, MO 63043
Phone (314) 434-9450

100 Piper Hill Dr
Ste D
Saint Peters, MO 63376
Phone (636) 928-3937

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1174183529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PIPER HILL DR STE D",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761616",
            "telephone_number": "256-997-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 MCKELVEY RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630431531",
            "telephone_number": "314-434-9450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Piper Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761616",
            "country_code": "US",
            "telephone_number": "636-928-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARENZA",
        "first_name": "AMY",
        "middle_name": "BROOKE MACKEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2019020522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryland Heights, MO

Sources for this page

Verify at the official NPI Registry.