Aric Joseph Waltz, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2020015173 Issued in MO

Practice address

6157 Mid Rivers Mall Dr
Saint Peters, MO 63304-1105

Phone

(636) 200-4393

NPI assigned

Jun 9, 2020

Last updated

Jun 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IA2 enrollments

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 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ophthalmic Holdings IncGroup PAC ID 0547239840, 2 clinicians

Greater Sioux Community Health Center IncGroup PAC ID 3173696572, 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aric.waltz.1@20239.direct.athenahealth.com
• Direct secure messaging: aricwaltz@direct.eyecare-partners.com

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.

• Greater Sioux Community Health Center Inc.

  dba Promise Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sioux Center, IA
  • NPI 1053582098
  Medicare reassignment Care Compare group NPD
• Ophthalmic Holdings Inc

  dba Family Eye Care

  • Optometrist
  • Orange City, IA
  • NPI 1548230410
  Medicare reassignment Care Compare group NPD
• Hawarden Family Eye Care PLLC

  • Optometrist
  • Hawarden, IA
  • NPI 1801560545
  Medicare reassignment NPD
• Clarkson Optometry, Inc

  • Optometrist
  • Ellisville, MO
  • NPI 1497155345
  Medicare reassignment
• Foureyes PLLC

  dba Family Eye Care - Rock Valley

  • Optometrist
  • Rock Valley, IA
  • NPI 1275198251
  Medicare reassignment
• Greater Sioux Community Health Center Inc.

  dba Promise CHC Sioux Center Intermediate School

  • Federally Qualified Health Center (FQHC)
  • Sioux Center, IA
  • NPI 1972398444
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1609491422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207158",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207158",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6157 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633041105",
            "telephone_number": "636-200-4393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6313 Ronald Reagan Dr",
            "address_purpose": "LOCATION",
            "city": "Lake St Louis",
            "state": "MO",
            "postal_code": "633672681",
            "country_code": "US",
            "telephone_number": "636-561-2342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "227 Salt Lick Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633765974",
            "country_code": "US",
            "telephone_number": "636-970-0250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 Zumbehl Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633032724",
            "country_code": "US",
            "telephone_number": "636-949-2906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "933 Highway K",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633662910",
            "country_code": "US",
            "telephone_number": "636-379-4288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "514 Warren County Ctr",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "MO",
            "postal_code": "633833023",
            "country_code": "US",
            "telephone_number": "636-377-2054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2946 Highway K",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633687861",
            "country_code": "US",
            "telephone_number": "636-240-1516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "390 Mid Rivers Mall Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761565",
            "country_code": "US",
            "telephone_number": "636-279-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17249 Chesterfield Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630051423",
            "country_code": "US",
            "telephone_number": "636-787-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1894 Wentzville Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633853820",
            "country_code": "US",
            "telephone_number": "636-887-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1423 Main St",
            "address_purpose": "LOCATION",
            "city": "Rock Valley",
            "state": "IA",
            "postal_code": "512471223",
            "country_code": "US",
            "telephone_number": "712-451-6540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33 4th St NW",
            "address_purpose": "LOCATION",
            "city": "Sioux Center",
            "state": "IA",
            "postal_code": "512501870",
            "country_code": "US",
            "telephone_number": "712-722-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Central Ave NW",
            "address_purpose": "LOCATION",
            "city": "Orange City",
            "state": "IA",
            "postal_code": "510411433",
            "country_code": "US",
            "telephone_number": "712-737-4246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTZ",
        "first_name": "ARIC",
        "middle_name": "JOSEPH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "101150",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2020015173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allisha Wall, LPC
• Jodie Wallis, CLC, MS, CCC-SLP
• Zamika A Walls
• Joseph Ryan Walsh, PA
• Rachel Kathleen Walthall, SLP
• Terry L. Ward, CRNA
• Warmann Chiropractic LLC (Warmann Chiropractic)
• Angela Marie Warner, WHNP
• Jessica Warner, MA, BCBA. LBA
• Jenna Warren

• Optometrist in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.