Stacey A Pruitt, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003010A Issued in IN

Practice address

1250 N State St
Greenfield, IN 46140-1055

Phone

(812) 614-1411

Fax

(317) 462-6342

NPI assigned

May 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stacey a Pruitt OD,Inc

  • Optometrist
  • Greenfield, IN
  • NPI 1508322009
  Medicare reassignment NPD Authorized official
• Clearview Eye Care of Indiana

  • Ophthalmology Physician
  • Indianapolis, IN
  • NPI 1891748497
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1700837069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10639 WINDJAMMER CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462368934",
            "telephone_number": "812-614-1411",
            "fax_number": "317-462-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 N STATE ST",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401055",
            "telephone_number": "812-614-1411",
            "fax_number": "317-462-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003010A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID NUMBER",
            "identifier": "P00447876",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200291080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prevail Prosthetics and Orthotics, Inc
• Price Eye Care, Inc
• Bayley Prince
• Jennifer Lyn Priser, ATC, LAT
• Progressive Care Solutions of in, LLC
• Amber Puckett
• Nadia Pumphrey
• Eric Pursell
• Ismail Qattash, M.D.
• Taylor Quarles, BCBA

• Optometrist in Greenfield, IN
• Providers in Greenfield, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2019; 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.

Verify at the official NPI Registry.