Amanda Jessie Bissell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2004025214 Issued in MO

Practice address

3071 Phoenix Center Dr
Washington, MO 63090-5690

Phone

(636) 777-2345

Fax

(636) 777-2115

NPI assigned

Jun 23, 2005

Sex

Female

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 2

Other names 1

• Amanda Williams Former name

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

Other, 2004

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)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Clarkson Optometry, Inc

  • Optometrist
  • Ellisville, MO
  • NPI 1497155345
  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Inc

  • Optometrist
  • Elk River, MN
  • NPI 1952992976
  NPD
• Clarkson Eyecare

  • Optometrist
  • Eureka, MO
  • NPI 1205817731
  NPD (past)
• Clarkson Optometry Inc

  • Optometrist
  • Fenton, MO
  • NPI 1114970779
  NPD (past)
• Clarkson Optometry Inc

  • Optometrist
  • Wentzville, MO
  • NPI 1689724486
  NPD (past)
• Nu-Crown, LLC

  • Optometrist
  • Alton, IL
  • NPI 1295737294
  NPD (past)

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": "1336145481",
    "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": "3071 PHOENIX CENTER DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905690",
            "telephone_number": "636-777-2345",
            "fax_number": "636-777-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSELL",
        "first_name": "AMANDA",
        "middle_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2004025214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319102232",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00374002",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILLIAMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle L Beumer
• Beyond the Horizon ABA
• Rajasekhar Reddy Bhoda, M.D
• Jennifer Biermann, PHARM.D.
• Kevin Michael Biermann, O.D.
• Mary Clare Blackburn, RN CDE
• Ashley Ann Blanchard, AG-ACNP-BC
• Christina Marie Blankenship, NP
• Beth Y Blankley, NP-BC
• Carl F Blatt Jr., M.D.

• Optometrist in Washington, MO
• Providers in Washington, 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.