Individual provider Active NPI

Amber Leigh Koester, O.D.

  • Optometrist
  • Chesterfield, MO
National Provider Identifier
1376696708
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2002015313 Issued in MO
Practice address
17249 Chesterfield Airport Rd
Chesterfield, MO 63005-1423
Phone
(636) 787-7000
Fax
(636) 787-0100
NPI assigned
Jan 19, 2007
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2952 MN
Optometrist 152W00000X 2002015313 MO Primary

Addresses

Primary practice location

17249 Chesterfield Airport Rd
Chesterfield, MO 63005-1423

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1376696708MedicaidMO

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
I20080314000146 MO Practitioner - Optometry 6709823040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2002
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)

17249 Chestefield Airport Rd
Chesterfield, MO 63005-1423
Phone (636) 787-7000

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2952MNMDChiropractor

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
Clarkson Eyecare Optometrist Past Accepting new patients

Locations

17249 Chesterfield Airport Rd
Chesterfield, MO 63005
Phone (636) 787-0085

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

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

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

Interoperability endpoints

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1376696708",
    "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": "17249 CHESTERFIELD AIRPORT RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051423",
            "telephone_number": "636-787-7000",
            "fax_number": "636-787-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOESTER",
        "first_name": "AMBER",
        "middle_name": "LEIGH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2952",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2002015313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376696708",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.