NPIMap

Organization Active NPI

Overland Optical, Inc

Doing business as Overland Optical Family Eye Care

  • Optician
  • Saint Charles, MO
National Provider Identifier
1396833174
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
036582 Issued in MO
Legal business name
OVERLAND OPTICAL, INC
Doing business as
Overland Optical Family Eye Care
Practice address
1529 S Old Highway 94 Ste 120
Saint Charles, MO 63303-3707
Phone
(636) 949-2900
NPI assigned
Oct 10, 2006
Last updated
Jan 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Mr. Russell G. Dentsbier, ABOC
Title
Owner/President
Phone
(314) 401-5570

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 036582 MO Primary

Addresses

Primary practice location

1529 S Old Highway 94 Ste 120
Saint Charles, MO 63303-3707

Mailing address

1529 S Old Highway 94 Ste 120
Saint Charles, MO 63303-3707
Phone (314) 423-3874

Other names 1

  • Overland Optical Family Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040607000222 MO Part B Supplier - Clinic/Group Practice 4284616814 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Overland, MO
O20100930064219 MO DME Supplier - Optician 4284616814 Practice locations: Saint Charles, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Overland Optical, Inc1529 S Old Highway 94, Saint Charles, MO 63303-3707(636) 949-2900 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

1529 S Old Highway 94
Ste 120
Saint Charles, MO 63303
Phone (636) 949-2900

1592 Country Club Plaza Dr
Saint Charles, MO 63303
Phone (636) 949-2900

2533 Woodson Rd
Saint Louis, MO 63114
Phone (314) 423-3874

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1396833174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 S OLD HIGHWAY 94 STE 120",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033707",
            "telephone_number": "314-423-3874",
            "fax_number": "888-423-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 S OLD HIGHWAY 94 STE 120",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033707",
            "telephone_number": "636-949-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAND OPTICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "DENTSBIER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "314-401-5570",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABOC"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "MO",
            "license": "036582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overland Optical Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Overland Optical Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.