Individual provider Active NPI

Matthew Clinton Schwamb, O.D.

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1609130434
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2012017908 Issued in MO
Practice address
917 Olive St
Saint Louis, MO 63101-1418
Phone
(314) 621-5303
Fax
(314) 621-7011
NPI assigned
Jun 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2012017908 MO Primary

Addresses

Primary practice location

917 Olive St
Saint Louis, MO 63101-1418

Mailing address

40 E North St
Eureka, MO 63025-1205
Phone (636) 200-4393

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
I20121005000552 MO Practitioner - Optometry 7012166051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry IncGroup PAC ID 0840411799, 82 clinicians

Practice addresses (Care Compare)

2121 Zumbehl Rd
Saint Charles, MO 63303-2724
Phone (636) 949-2906

3122 S Grand Blvd
The Spec Shoppe
St Louis, MO 63118-1012
Phone (314) 450-7313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2012017908MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Eyecare Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: matthewschwamb@direct.eyecare-partners.com

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1609130434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E NORTH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-200-4393",
            "fax_number": "636-938-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011418",
            "telephone_number": "314-621-5303",
            "fax_number": "314-621-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWAMB",
        "first_name": "MATTHEW",
        "middle_name": "CLINTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2012017908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.