Individual provider Active NPI

Carrie L. Hartigan, OD

  • Optometrist
  • Springfield, MO
National Provider Identifier
1528409158
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2013020890 Issued in MO
Practice address
1229 E Seminole St
4TH FL
Springfield, MO 65804-2227
Phone
(417) 820-9393
Fax
(417) 820-9725
NPI assigned
Jul 11, 2013
Last updated
Nov 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2013020890 MO Primary

Addresses

Primary practice location

1229 E Seminole St
4TH FL
Springfield, MO 65804-2227

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers 4

IdentifierTypeStateIssuer
1528409158MedicaidMO
199216722MedicaidAR
P01222591OtherMORR MCR
431560263OtherMOTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20220502002102 KS Practitioner - Optometry 5395989305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgeview Eye Care LLCGroup PAC ID 2668547621, 6 clinicians

Practice addresses (Care Compare)

18208 W 119TH St
Olathe, KS 66061-9507
Phone (913) 261-8327

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013020890MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Eye Care LLC Optometrist CurrentSince Jun 1, 2022 Accepting new patients
Ad Astra Eye, LLC PastSince Jun 1, 2022 Accepting new patients

Locations

33321 Lexington Ave
De Soto, KS 66018
Phone (913) 583-1991

18208 W 119th St
Olathe, KS 66061
Phone (913) 261-8327

Interoperability endpoints

  • Direct secure messaging: chartigan351805@directb.mercy.net

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1528409158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "address_2": "4TH FL",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-9393",
            "fax_number": "417-820-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTIGAN",
        "first_name": "CARRIE",
        "middle_name": "L.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2013020890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528409158",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199216722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01222591",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.