Douglas G Rose, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2002016606 Issued in MO

Practice address

390 Mid Rivers Mall Dr
Suite 290
Saint Peters, MO 63376-1565

Phone

(636) 279-2020

Fax

(636) 279-1055

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Ophthalmology LLCGroup PAC ID 1951544428, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: drose746757@directc.mercy.net

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.

• Mercy Clinic Ophthalmology LLC

  • Ophthalmology Physician
  • Washington, MO
  • NPI 1003179656
  Medicare reassignment Care Compare group
• Jennings Eye Associates, P.C.

  • Optometrist
  • Columbia, MO
  • NPI 1871649020
  NPD (past)
• Lens Mart Inc

  • Eyewear Supplier
  • Camdenton, MO
  • NPI 1275566044

  Optometrist

  NPD (past)
• Overland Optical, Inc

  dba Overland Optical Family Eye Care

  • Optician
  • Saint Charles, MO
  • NPI 1396833174
  NPD (past)
• Overland Optical, Inc.

  dba Overland Optical Family Eye Care

  • Optician
  • Saint Louis, MO
  • NPI 1457377848
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1285654418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E NORTH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-200-4393",
            "fax_number": "636-938-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 MID RIVERS MALL DR",
            "address_2": "SUITE 290",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761565",
            "telephone_number": "636-279-2020",
            "fax_number": "636-279-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DOUGLAS",
        "middle_name": "G",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2002016606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285654418",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Renee Rogers, MA, LCPC, LPC
• Rachel Rojano, RD
• John Edward Romeo, FNP-BC
• Delaina C Root, OT
• Hannah Noelle Roscow
• Lori Wulf Roseman, D.D.S.
• Linda Sue Rosemann, RPH
• Anna Roshal, MD
• Dennis D Roth, PT, DPT
• Richard Charles Rothweiler, RN

• Optometrist in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.