Individual provider Active NPI

Andrew Joseph Biondo, O.D.

  • Optometrist
  • Kirkwood, MO
National Provider Identifier
1407143175
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2011018480 Issued in MO
Practice address
200 S Kirkwood Rd Ste 130
Kirkwood, MO 63122-4335
Phone
(314) 394-3045
Fax
(314) 394-3049
NPI assigned
Jul 1, 2011
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2011018480 MO Primary

Addresses

Primary practice location

200 S Kirkwood Rd Ste 130
Kirkwood, MO 63122-4335

Mailing address

200 S Kirkwood Rd Ste 130
Kirkwood, MO 63122-4335
Phone (314) 394-3045

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
I20110822000383 MO Practitioner - Optometry 1557531944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirkwood Eye Associates LLCGroup PAC ID 3779884986, 3 clinicians

Practice addresses (Care Compare)

200 S Kirkwood Rd
Suite 130
Kirkwood, MO 63122-4335
Phone (314) 394-3045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011018480MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kirkwood Eye Associates LLC Optometrist CurrentSince Oct 13, 2014 Accepting new patients
Eye Associates Partners LLC Optometrist CurrentSince May 1, 2022 Accepting new patients

Locations

101 S Central Ave
Eureka, MO 63025
Phone (636) 938-9092

200 S Kirkwood Rd
Ste 100
Saint Louis, MO 63122
Phone (314) 394-3045

200 S Kirkwood Rd
Ste 130
Saint Louis, MO 63122
Phone (314) 394-3045

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, 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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1407143175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S KIRKWOOD RD STE 130",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631224335",
            "telephone_number": "314-394-3045",
            "fax_number": "314-394-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S KIRKWOOD RD STE 130",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631224335",
            "telephone_number": "314-394-3045",
            "fax_number": "314-394-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIONDO",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011018480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

Verify at the official NPI Registry.