Individual provider Active NPI

David Thomas Tischinski, OD

  • Optometrist
  • Gladstone, MO
National Provider Identifier
1407839756
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2002017827 Issued in MO
Practice address
6080 N. Oak
Oakview Medical Building
Gladstone, MO 64118
Phone
(816) 454-2020
Fax
(816) 453-2659
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2002017827 MO Primary

Addresses

Primary practice location

6080 N. Oak
Oakview Medical Building
Gladstone, MO 64118

Mailing address

2441 NW Prairie View Rd
Platte City, MO 64079
Phone (816) 858-2522

Other identifiers 1

IdentifierTypeStateIssuer
316013606MedicaidMO

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
I20110819000557 MO Practitioner - Optometry 2062567365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bennett Eyecare Midwest LLCGroup PAC ID 5890840185, 7 clinicians

Practice addresses (Care Compare)

1504 N Church Rd
Liberty, MO 64068-7129
Phone (816) 781-3442

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2002017827MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bennett Eyecare Midwest LLC Optometrist CurrentSince Aug 12, 2002 Accepting new patients
Bennett Eyecare Midwest LLC Optometrist CurrentSince Aug 12, 2002 Accepting new patients

Locations

3417 NW Mill Dr
Blue Springs, MO 64015
Phone (816) 229-3001

6080 N Oak Trfy
Ste 101
Gladstone, MO 64118
Phone (816) 454-2020

6080 N Oak Trfy
Kansas City, MO 64118
Phone (816) 221-9898

1504 N Church Rd
Liberty, MO 64068
Phone (816) 781-3442

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1407839756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 NW PRAIRIE VIEW RD",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "64079",
            "telephone_number": "816-858-2522",
            "fax_number": "816-858-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 N. OAK",
            "address_2": "OAKVIEW MEDICAL BUILDING",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64118",
            "telephone_number": "816-454-2020",
            "fax_number": "816-453-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISCHINSKI",
        "first_name": "DAVID",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2002017827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316013606",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

Verify at the official NPI Registry.