Individual provider Active NPI

St. Clair Reeves La Roche, O.D.

  • Optometrist
  • Farmville, VA
National Provider Identifier
1730593229
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002335 Issued in VA
Practice address
1511 W 3Rd St
Farmville, VA 23901-2649
Phone
(434) 392-9555
Fax
(434) 392-1524
NPI assigned
Jun 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002335 VA Primary

Addresses

Primary practice location

1511 W 3Rd St
Farmville, VA 23901-2649

Mailing address

PO Box 506
Farmville, VA 23901-0506
Phone (434) 392-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20141008000272 VA Practitioner - Optometry 6608096920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southside Eye Center PCGroup PAC ID 7315075231, 3 clinicians
Eye Care Center of Virginia PCGroup PAC ID 9133164320, 4 clinicians

Practice addresses (Care Compare)

1511 W 3Rd St
Farmville, VA 23901-2649
Phone (434) 392-9555

605 N Courthouse Rd
Suite 101
North Chesterfield, VA 23236-4068
Phone (804) 794-1334

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002335VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Eye Center PC CurrentSince Jun 14, 2014 Accepting new patients
Southside Optical Center LLC Past Accepting new patients

Locations

1511 W 3rd St
Farmville, VA 23901
Phone (434) 392-9555

Interoperability endpoints

  • Direct secure messaging: srlaroche@southsideeyecenter.direct.eyemdemr.com

Organizations & group practices 3

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1730593229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239010506",
            "telephone_number": "434-392-9555",
            "fax_number": "434-392-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 W 3RD ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012649",
            "telephone_number": "434-392-9555",
            "fax_number": "434-392-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA ROCHE",
        "first_name": "ST. CLAIR",
        "middle_name": "REEVES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmville, VA

Sources for this page

Verify at the official NPI Registry.