Edward Omer Obermark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T03188 Issued in MO

Practice address

222 W Main St
Washington, MO 63090-2123

Phone

(636) 239-7144

Fax

(636) 239-6266

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Edward Omer Obermark Professional name

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edwardobermark@direct.revolutionehr.com

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.

• Obermark Optometry, Inc

  • Optometrist
  • Washington, MO
  • NPI 1275710014
  Medicare reassignment NPD
• Obermark Optometry, Inc.

  • Optometrist
  • Belle, MO
  • NPI 1619145794
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720019375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W MAIN ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902123",
            "telephone_number": "636-239-7144",
            "fax_number": "636-239-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W MAIN ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902123",
            "telephone_number": "636-239-7144",
            "fax_number": "636-239-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERMARK",
        "first_name": "EDWARD",
        "middle_name": "OMER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317927903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWARD",
            "last_name": "OBERMARK",
            "middle_name": "OMER",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Charles Upshur Nottingham, MD
• Julie Ann Novak-Eversole
• Nu-Crown, LLC
• Megan Nicole Oberg, CPM
• Obermark Optometry, Inc
• Melissa Ann Ohm, DPT
• Kelly Anne Oreskovic, LCSW
• Kyle Fritz Ostrom, M.D.
• Amanda Anne Oswalt, FNP-BC
• Our Urgent Care, LLC

• Optometrist in Washington, MO
• Providers in Washington, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.