NPIMap

Organization Active NPI

Seibert Mobile Optometry LLC

  • Optometrist
  • Jefferson City, MO
National Provider Identifier
1679017362
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02387 Issued in MO
Legal business name
SEIBERT MOBILE OPTOMETRY LLC
Practice address
221 Bolivar St
Jefferson City, MO 65101-1572
Phone
(502) 579-1797
Fax
(502) 996-8282
NPI assigned
Dec 14, 2016
Last updated
Jan 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Daniel Seibert, OD
Title
Owner
Phone
(502) 579-1797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X T02387 MO Primary

Addresses

Primary practice location

221 Bolivar St
Jefferson City, MO 65101-1572

Mailing address

221 Bolivar St
Jefferson City, MO 65101-1572
Phone (502) 579-1797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170330000287 MO Part B Supplier - Clinic/Group Practice 7517242746 Receives reassigned benefits from 13 practitioners
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

143 Replacement Ave
Bldg 487
Fort Leonard Wood, MO 65473
Phone (573) 329-0130

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1679017362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 BOLIVAR ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651011572",
            "telephone_number": "502-579-1797",
            "fax_number": "502-996-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 BOLIVAR ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651011572",
            "telephone_number": "502-579-1797",
            "fax_number": "502-996-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEIBERT MOBILE OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-14",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "SEIBERT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-579-1797",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.