Individual provider Active NPI

Carrie T Hruza, O.D.

  • Optometrist
  • Fenton, MO
National Provider Identifier
1700870284
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2002027795 Issued in MO
Practice address
1011 Bowles Ave
Suite 200
Fenton, MO 63026-2395
Phone
(636) 717-1700
Fax
(636) 203-4727
NPI assigned
Sep 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 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 2002027795 MO Primary

Addresses

Primary practice location

1011 Bowles Ave
Suite 200
Fenton, MO 63026-2395

Mailing address

1011 Bowles Ave
Suite 200
Fenton, MO 63026-2395
Phone (636) 717-1700

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
I20090722000040 MO Practitioner - Optometry 6901958917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Envision Eye Specialists PCGroup PAC ID 0042375941, 6 clinicians

Practice addresses (Care Compare)

1011 Bowles Ave
Suite 200
Fenton, MO 63026-2384
Phone (636) 717-1700

Merit-based Incentive Payment System (MIPS)

Final score
91.88 of 100Reported as group
Quality
83.76
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Eye Specialists PC CurrentSince Oct 1, 2013 Accepting new patients

Locations

1390 W Liberty St
Farmington, MO 63640
Phone (314) 835-9400

1011 Bowles Ave
Ste 115
Fenton, MO 63026
Phone (636) 343-6664

1011 Bowles Ave
Ste 200
Fenton, MO 63026
Phone (636) 343-6664

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1700870284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE",
            "address_2": "SUITE 200",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262395",
            "telephone_number": "636-717-1700",
            "fax_number": "636-203-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE",
            "address_2": "SUITE 200",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262395",
            "telephone_number": "636-717-1700",
            "fax_number": "636-203-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRUZA",
        "first_name": "CARRIE",
        "middle_name": "T",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2002027795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.