Organization Active NPI

O'Fallon Family Eye Care LLC

  • Optometrist
  • O Fallon, MO
National Provider Identifier
1295030922
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2004030855 Issued in MO
Legal business name
O'FALLON FAMILY EYE CARE LLC
Practice address
4142 Keaton Crossing Blvd Ste 102
O Fallon, MO 63368-8403
Phone
(636) 614-4655
NPI assigned
Jan 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Dr. Joseph P Hegyi, O.D.NPI 1649263856
Title
Owner
Phone
(314) 775-7352

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2004030855 MO Primary

Addresses

Primary practice location

4142 Keaton Crossing Blvd Ste 102
O Fallon, MO 63368-8403

Mailing address

4142 Keaton Crossing Blvd Ste 102
O Fallon, MO 63368-8403
Phone (636) 614-4655

Other names 1

  • O'Fallon Family Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110526000029 MO Part B Supplier - Clinic/Group Practice 0143406223 Receives reassigned benefits from 2 practitioners
Practice locations: O Fallon, MO

National Provider Directory

National Provider Directory

Locations

4142 Keaton Crossing Blvd
Ste 102
O Fallon, MO 63368
Phone (636) 205-4639

4142 Keaton Crossing Blvd
Ste 103
O Fallon, MO 63368
Phone (636) 614-4655

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1295030922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4142 KEATON CROSSING BLVD STE 102",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688403",
            "telephone_number": "636-614-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4142 KEATON CROSSING BLVD STE 102",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688403",
            "telephone_number": "636-614-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'FALLON FAMILY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "HEGYI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-775-7352",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2004030855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "O'Fallon Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.