Alexandria Paige Holmes, OD

Individual provider Active NPI Optometrist · Republic, MO

NPI 1194237826 · NPPES record last updated Sep 27, 2019

Key facts

NPI
1194237826
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
2018021504 (MO)
Practice address
612 E Elm St
Republic, MO 65738
Phone
(417) 732-5575
Fax
(417) 732-4245
NPI assigned
Nov 3, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntress Visionhealth Associates LLC (5 clinicians)

Practice addresses (Care Compare)

215 4TH St
Monett, MO 65708-2314
Phone (417) 235-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180705002293 MO Practitioner - Optometry 7113273137 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2018021504MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntress Visionhealth Associates LLC Optometrist Current
since Jun 22, 2018
Accepting new patients

Locations

215 4th St
Monett, MO 65708
Phone (417) 235-2020

612 E Elm St
Republic, MO 65738
Phone (417) 732-5575

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2018021504 MO Yes

Addresses

Primary practice location

612 E Elm St
Republic, MO 65738

Mailing address

3660 S Cox Ave Apt 3204
Springfield, MO 65807-6969

Other practice location 1

215 4th St
Monett, MO 65708-2314
Phone (417) 235-2020

Other providers in Republic, MO

All providers in Republic, MO · Optometrist in Missouri

Sources for this page

Verify at the official NPI Registry.