Active NPI
Steven E Rosen, OD
- Optometrist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TO2404
- Practice address
- 474 Crestwood PLZ
Saint Louis, MO 63126-1704 - Phone
- (314) 968-3660
- Fax
- (314) 968-3559
- NPI assigned
- Dec 6, 2005
- Last updated
- Apr 30, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TO2404 | MO | Primary |
| Optometrist | 152W00000X | 582 | AZ |
Addresses
Primary practice location
474 Crestwood PLZ
Saint Louis, MO 63126-1704
Mailing address
1324 Conway Oaks Dr
Chesterfield, MO 63017-1958
Phone (636) 537-1377
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 311723613 | Medicaid | MO | |
| 21537 | Other | MO | HEALTHCARE USA |
| 108646 | Other | MO | BCBS OF MISSOURI |
| 254718 | Other | MO | HEALTHLINK |
| 31297 | Other | MO | OPTICARE-OEHN |
| 22-00854 | Other | MO | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6615 N Oracle Rd
Tucson, AZ 85704-5644
Phone (520) 797-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 582 | AZ | MD | Optometrist |
| TO2404 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Eyecare, LLC | Optometrist | Current | Accepting new patients |
| John H McDougall OD Arizona PC | Optometrist | Current | Accepting new patients |
| Rosen Optometry Associates Inc | Optometrist | Past | Accepting new patients |
| Rosen Optometry Associates Inc | Optometrist | Past | Accepting new patients |
Locations
13125 N La Montana Dr
Ste 1
Fountain Hls, AZ 85268
Phone (480) 816-0102
440 N Alvernon Way
Tucson, AZ 85711
Phone (520) 327-6211
6615 N Oracle Rd
Tucson, AZ 85704
Phone (520) 797-8000
111 E 4th St
Ste 440
Alton, IL 62002
17 Ronnies Plz
Saint Louis, MO 63126
Phone (314) 843-2020
Organizations & group practices 4
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.
-
dba 20/20 Image Eye Centers
- Optometrist
- Fountain Hills, AZ
- NPI 1851882179
-
- Optometrist
- Saint Louis, MO
- NPI 1215903240
-
- Optometrist
- Saint Louis, MO
- NPI 1548231947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1619951274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1324 CONWAY OAKS DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630171958",
"telephone_number": "636-537-1377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "474 CRESTWOOD PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631261704",
"telephone_number": "314-968-3660",
"fax_number": "314-968-3559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEN",
"first_name": "STEVEN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "TO2404",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "582",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "311723613",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE USA",
"identifier": "21537",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MISSOURI",
"identifier": "108646",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "254718",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTICARE-OEHN",
"identifier": "31297",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "22-00854",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.