NPIMap

Individual provider Active NPI

Michael J. Katich, O.D.

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1669449765
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO2861 Issued in MO
Practice address
4305 Butler Hill Rd
Saint Louis, MO 63128-3718
Phone
(314) 487-4744
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO2861 MO Primary

Addresses

Primary practice location

4305 Butler Hill Rd
Saint Louis, MO 63128-3718

Mailing address

PO Box 207158
Dallas, TX 75320-7158
Phone (636) 200-4393

Other practice location 1

343 S Kirkwood Rd
Kirkwood, MO 63122-6195
Phone (314) 965-6773

Other practice location 2

343 S Kirkwood Rd
Kirkwood, MO 63122-6195
Phone (314) 965-6773

Other identifiers 10

IdentifierTypeStateIssuer
12062OtherOPTICAREMEDICARE COMPLETE
179835OtherHEALTHLINK
410048086OtherILRR MEDICARE
100684OtherBLUE CROSS BLUE SHIELD MO
110969OtherEYEMED
22-01200OtherUNITED HEALTHCARE
4185OtherMOHEALTHCARE USA
000091336OtherMOMEDICARE PART B PTAN
313428427MedicaidMO
P00403019OtherMORR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091111000060 MO Practitioner - Optometry 8628116746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry Inc 82 clinicians

Practice addresses (Care Compare)

2572 Lemay Ferry Rd
Saint Louis, MO 63125-3131
Phone (314) 892-3321

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

3936 Vogel Rd
Arnold, MO 63010-3790
Phone (636) 262-4982

5632 A Telegraph Rd
Saint Louis, MO 63129-4243
Phone (313) 334-7000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO2861MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Inc Optometrist Past Accepting new patients

Interoperability endpoints

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

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1669449765",
    "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": "4305 BUTLER HILL RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283718",
            "telephone_number": "314-487-4744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 S Kirkwood Rd",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "MO",
            "postal_code": "631226195",
            "country_code": "US",
            "telephone_number": "314-965-6773",
            "fax_number": "800-432-6004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "343 S Kirkwood Rd",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "MO",
            "postal_code": "631226195",
            "country_code": "US",
            "telephone_number": "314-965-6773",
            "fax_number": "800-432-6004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATICH",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICAREMEDICARE COMPLETE",
            "identifier": "12062",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "179835",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410048086",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MO",
            "identifier": "100684",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "110969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "22-01200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "4185",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B PTAN",
            "identifier": "000091336",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313428427",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00403019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.