Individual provider Active NPI

Jerry Kassel, O.D.

  • Optometrist
  • Arnold, MO
National Provider Identifier
1306842398
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03445 Issued in MO
Practice address
3936 Vogel Rd
Arnold, MO 63010-3790
Phone
(636) 282-4982
Fax
(636) 296-3376
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03445 MO Primary

Addresses

Primary practice location

3936 Vogel Rd
Arnold, MO 63010-3790

Mailing address

40 E North St
Eureka, MO 63025-1205
Phone (636) 200-4393

Other identifiers 2

IdentifierTypeStateIssuer
314739830MedicaidMO
410046214OtherMORAILROAD MEDICARE

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
I20110221000130 MO Practitioner - Optometry 0840471165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry IncGroup PAC ID 0840411799, 82 clinicians

Practice addresses (Care Compare)

3122 S Grand Blvd
The Spec Shoppe
St Louis, MO 63118-1012
Phone (314) 450-7313

3936 Vogel Rd
Arnold, MO 63010-3790
Phone (636) 262-4982

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T03445MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry, Inc Optometrist CurrentSince Aug 20, 2014 Accepting new patients
Clarkson Optometry Inc Optometrist CurrentSince Aug 20, 2014 Accepting new patients
Brost & Strohmeyer Family Eye Care PC Optometrist Past Accepting new patients
Clarkson Eyecare Optometrist Past Accepting new patients
Brost & Associates Family Eye Care PC Optometrist PastSince Jul 1, 1996 Accepting new patients

Locations

3936 Vogel Rd
Arnold, MO 63010
Phone (636) 262-4982

330 W Osage St
Pacific, MO 63069
Phone (636) 271-4500

11433 Olive Blvd
Saint Louis, MO 63141
Phone (314) 432-1134

4305 Butler Hill Rd
Saint Louis, MO 63128
Phone (314) 487-4744

3122 S Grand Blvd
Saint Louis, MO 63118
Phone (314) 450-7313

514 Warren County Ctr
Warrenton, MO 63383
Phone (636) 377-2054

Interoperability endpoints

  • Direct secure messaging: jerrykassel@direct.eyecare-partners.com

Organizations & group practices 5

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1306842398",
    "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": "3936 VOGEL RD",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630103790",
            "telephone_number": "636-282-4982",
            "fax_number": "636-296-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSEL",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314739830",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410046214",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MO

Sources for this page

Verify at the official NPI Registry.