Individual provider Active NPI

Julie Lynn Dekinder, OD

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1346356086
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2004018570 Issued in MO
Practice address
7840 Natural Bridge Rd
Patient Care Center
Saint Louis, MO 63121-4617
Phone
(314) 516-5161
Fax
(314) 516-5507
NPI assigned
Aug 23, 2006
Last updated
Jun 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2004018570 MO Primary
Corneal and Contact Management Optometrist 152WC0802X 2004018570 MO

Addresses

Primary practice location

7840 Natural Bridge Rd
Patient Care Center
Saint Louis, MO 63121-4617

Mailing address

1 University Blvd
Patient Care Center
Saint Louis, MO 63121-4400
Phone (314) 516-5116

Other practice location 1

3940 Lindell Blvd
Saint Louis, MO 63108-3204
Phone (314) 516-5016

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
I20050126000137 MO Practitioner - Optometry 3274583489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Northeastern Ohio University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curators of the University of MissouriGroup PAC ID 6800704560, shared by 12 NPIs, 19 clinicians

Practice addresses (Care Compare)

3940 Lindell Blvd
Saint Louis, MO 63108-3204
Phone (314) 516-5016

7840 Natural Bridge Rd
Saint Loius, MO 63121-4617
Phone (314) 516-5131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004018570MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri Optometrist CurrentSince Jul 1, 2004 Accepting new patients
Curators of the University of Missouri CurrentSince Jul 1, 2004 Accepting new patients
Curators of the University of Missouri Optometrist CurrentSince Jul 1, 2004 Accepting new patients

Locations

1 University Blvd
Saint Louis, MO 63121
Phone (314) 516-5131

1 University Blvd
#115
Saint Louis, MO 63121

3940 Lindell Blvd
Saint Louis, MO 63108
Phone (314) 516-5016

7840 Natural Bridge Rd
Saint Louis, MO 63121
Phone (314) 382-6400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1346356086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY BLVD",
            "address_2": "PATIENT CARE CENTER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214400",
            "telephone_number": "314-516-5116",
            "fax_number": "314-516-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 NATURAL BRIDGE RD",
            "address_2": "PATIENT CARE CENTER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214617",
            "telephone_number": "314-516-5161",
            "fax_number": "314-516-5507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3940 Lindell Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631083204",
            "country_code": "US",
            "telephone_number": "314-516-5016",
            "fax_number": "314-535-4741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKINDER",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2004018570",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MO",
            "license": "2004018570",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.