Amir Sahba Jalali, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

2001006508 Issued in MO

Practice address

340 Kelley Pkwy
Mexico, MO 65265-3811

Phone

(573) 582-1234

Fax

(573) 582-1212

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, Columbia School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pec Columbia Inc 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amir.jalali.p1@direct.arthurcenter.nextgenshare.com
• Direct secure messaging: drjalali@advancedvision.direct.eyemdemr.com
• Direct secure messaging: amir.jalali.p1@direct.pfh.nextgenshare.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.

• Pec Columbia, Inc

  • Optometrist
  • Columbia, MO
  • NPI 1215158910

  MO

  Medicare reassignment Care Compare group NPD
• East Central Missouri Behavioral Health Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mexico, MO
  • NPI 1144293549

  MO

  Medicare reassignment NPD
• Pec Warrenton LLC

  • Optometrist
  • Warrenton, MO
  • NPI 1043829088

  MO

  Medicare reassignment NPD
• Preferred Family Healthcare, Inc

  • Community/Behavioral Health Agency
  • Kirksville, MO
  • NPI 1649474206

  MO

  Medicare reassignment NPD
• East Central Missouri Behavioral Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Montgomery City, MO
  • NPI 1376164699
  NPD
• Preferred Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hannibal, MO
  • NPI 1306721709
  NPD
• Ernst Eye Health Associates, Inc

  • Eyewear Supplier
  • Warrenton, MO
  • NPI 1245411776
  NPD (past)
• Preferred Family Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Columbia, MO
  • NPI 1750160578
  NPD (past)
• International Eyecare Center, Inc.

  • Optometrist
  • Lavista, NE
  • NPI 1740461979

  Corneal and Contact Management

  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1346334166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALALI",
        "first_name": "AMIR",
        "middle_name": "SAHBA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MO",
            "license": "2001006508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgetta Jean Hull, LCSW
• Image Chiropractic PC
• International Eyecare Center, Inc
• Christian Jackson, LMSW
• Diane Jean Jacobi, M.D.
• Nicole Marie James, LCSW
• Cara Rae Johnson, MSW, PSY.D.
• Ben L Jolly, M.D.
• William Harrison Jolly, DDS
• Michael D Jones, MD

• All providers in Mexico, MO
• Corneal and Contact Management Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.