Individual provider Active NPI

Jeffrey Alan Kempf, O.D.

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1386604411
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2003002151 Issued in MO
Practice address
6451 Chippewa St
Saint Louis, MO 63109-2104
Phone
(314) 353-6171
Fax
(314) 353-0031
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2003002151 MO Primary
Optometrist 152W00000X 046009391 IL

Addresses

Primary practice location

6451 Chippewa St
Saint Louis, MO 63109-2104

Mailing address

6451 Chippewa St
Saint Louis, MO 63109-2104
Phone (314) 353-6171

Other identifiers 1

IdentifierTypeStateIssuer
046009391MedicaidIL

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
I20070417000262 MO Practitioner - Optometry 3678678844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premium Vision Solutions LLCGroup PAC ID 4587896303, 2 clinicians

Practice addresses (Care Compare)

6451 Chippewa St
Saint Louis, MO 63109-2104
Phone (314) 353-6171

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009391ILMDOptometrist
2003002151MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Vision Solutions, LLC Optometrist CurrentSince Jan 1, 2014 Accepting new patients
Fontana Eyecare Associates, LLC. Past Accepting new patients

Locations

6451 Chippewa St
Saint Louis, MO 63109
Phone (314) 353-6171

16 Hampton Village Plz
Ste 249
Saint Louis, MO 63109
Phone (314) 353-6171

Organizations & group practices 2

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1386604411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092104",
            "telephone_number": "314-353-6171",
            "fax_number": "314-353-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092104",
            "telephone_number": "314-353-6171",
            "fax_number": "314-353-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPF",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2003002151",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009391",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009391",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.