Individual provider Active NPI

Anne Marie St. Louis, O.D.

  • Optometrist
  • Waterford, MI
National Provider Identifier
1730520933
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004790 Issued in MI
Practice address
4486 W Walton Blvd
Waterford, MI 48329-4073
Phone
(248) 673-7601
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004790 MI Primary

Addresses

Primary practice location

4486 W Walton Blvd
Waterford, MI 48329-4073

Mailing address

4486 W Walton Blvd
Waterford, MI 48329-4073
Phone (248) 673-7601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20131030000417 MI Practitioner - Optometry 3173758018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4486 W Walton Blvd
Waterford, MI 48329-4073
Phone (248) 673-7601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard J. St. Louis O.D. PLLC CurrentSince Sep 1, 2013 Accepting new patients
Richard J. St. Louis O.D. P.C. Optometrist PastSince Sep 1, 2013 Accepting new patients

Locations

4486 W Walton Blvd
Waterford, MI 48329
Phone (248) 356-1330

Organizations & group practices 2

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": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1730520933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4486 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294073",
            "telephone_number": "248-673-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4486 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294073",
            "telephone_number": "248-673-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. LOUIS",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.