Individual provider Active NPI

Steven E Rosen, OD

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1619951274
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO2404 Issued in MO
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, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
311723613MedicaidMO
21537OtherMOHEALTHCARE USA
108646OtherMOBCBS OF MISSOURI
254718OtherMOHEALTHLINK
31297OtherMOOPTICARE-OEHN
22-00854OtherMOUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AZ2 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

Enrollment IDStateProvider typePAC IDDetails
I20100727000986 MO Practitioner - Optometry 8426947615 Reassigns benefits to 1 organization
I20190417002805 AZ Practitioner - Optometry 8426947615 Reassigns benefits to 1 organization

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
John H McDougall OD Arizona PCGroup PAC ID 3274880117, 44 clinicians

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

LicenseStateTypeSpecialty
582AZMDOptometrist
TO2404MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Eyecare, LLC Optometrist CurrentSince Dec 28, 2018 Accepting new patients
John H McDougall OD Arizona PC Optometrist CurrentSince Oct 15, 2022 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.

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

Verify at the official NPI Registry.