Individual provider Active NPI

Erin Genua, O.D.

  • Optometrist
  • Springfield, MO
National Provider Identifier
1184880692
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2008017923 Issued in MO
Practice address
1650 S Enterprise Ave
Springfield, MO 65804-1800
Phone
(417) 889-7788
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2008017923 MO Primary

Addresses

Primary practice location

1650 S Enterprise Ave
Springfield, MO 65804-1800

Mailing address

1650 S Enterprise Ave
Springfield, MO 65804-1800

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
I20081215000253 MO Practitioner - Optometry 3870655590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bolivar Vision, LLCGroup PAC ID 6608190152, 4 clinicians

Practice addresses (Care Compare)

680 E Aldrich Rd
Bolivar, MO 65613-2573
Phone (417) 777-9000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008017923MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bolivar Vision, LLC Optometrist CurrentSince Mar 15, 2016 Accepting new patients
Missouri Eye Institute LLC Optometrist PastSince Mar 15, 2016 Accepting new patients

Locations

325 S Main Ave
Bolivar, MO 65613
Phone (417) 777-9000

680 E Aldrich Rd
Bolivar, MO 65613
Phone (417) 777-9000

Interoperability endpoints

  • Direct secure messaging: erin.genua@direct.revolutionehr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1184880692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S ENTERPRISE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S ENTERPRISE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041800",
            "telephone_number": "417-889-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENUA",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2008017923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.