Individual provider Active NPI

Brian Patrick Sumner, OD.

  • Optometrist
  • Washington, MO
National Provider Identifier
1588667992
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO2351 Issued in MO
Practice address
320 Washington Ave
Washington, MO 63090-3218
Phone
(636) 239-2179
Fax
(636) 239-9592
NPI assigned
May 31, 2005
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO2351 MO Primary

Addresses

Primary practice location

320 Washington Ave
Washington, MO 63090-3218

Mailing address

320 Washington Ave
Washington, MO 63090-3218
Phone (636) 239-2179

Other identifiers 5

IdentifierTypeStateIssuer
2202100OtherMOUNITED HEALTH CARE
233006OtherMOGROUP HEALTH PLAN
122489OtherMOHEALTHLINK
310206214MedicaidMO
32218OtherMOBLUE CROSS BLUE SHIELD

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
I20100818000240 MO Practitioner - Optometry 4587798145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Biermann Eye Health P.C.Group PAC ID 0143453506, 3 clinicians

Practice addresses (Care Compare)

320 Washington Ave
Washington, MO 63090-3218
Phone (636) 239-2179

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO2351MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Biermann Eye Health P.C. Optometrist CurrentSince Dec 11, 2020 Accepting new patients

Locations

320 Washington Ave
Washington, MO 63090
Phone (314) 239-2179

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1588667992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WASHINGTON AVE",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903218",
            "telephone_number": "636-239-2179",
            "fax_number": "636-239-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WASHINGTON AVE",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903218",
            "telephone_number": "636-239-2179",
            "fax_number": "636-239-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "OD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2202100",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "233006",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "122489",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310206214",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "32218",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.