Individual provider Active NPI

Alexander Donald Harris, OD

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1659487387
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02692 Issued in MO
Practice address
7800 Natural Bridge Rd
1 University Blvd
Saint Louis, MO 63121-4617
Phone
(314) 516-5131
Fax
(314) 516-5507
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02692 MO Primary

Addresses

Primary practice location

7800 Natural Bridge Rd
1 University Blvd
Saint Louis, MO 63121-4617

Mailing address

One University Blvd
115 Marillac Hall
St Louis, MO 63121
Phone (314) 516-5131

Other identifiers 1

IdentifierTypeStateIssuer
1659487387MedicaidMO

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
I20060111000740 MO Practitioner - Optometry 7012930456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel D Seibert OD PCGroup PAC ID 7315977873, 2 clinicians

Practice addresses (Care Compare)

2040 Woodson Rd
Suite 100
Overland, MO 63114-5606
Phone (314) 427-1519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02629MOMDOptometrist
T02692MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel D Seibert OD PC Optometrist CurrentSince Sep 20, 2005 Accepting new patients

Locations

2040 Woodson Rd
Ste 100
Saint Louis, MO 63114
Phone (314) 427-1519

Organizations & group practices 1

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1659487387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE UNIVERSITY BLVD",
            "address_2": "115 MARILLAC HALL",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63121",
            "telephone_number": "314-516-5131",
            "fax_number": "314-516-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 NATURAL BRIDGE RD",
            "address_2": "1 UNIVERSITY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214617",
            "telephone_number": "314-516-5131",
            "fax_number": "314-516-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ALEXANDER",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659487387",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.