Paul B Stauder

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009085 Issued in IL

Practice address

101 E Delaware St
Suite C
Fairfield, IL 62837-2111

Phone

(618) 842-6516

NPI assigned

Oct 10, 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

Medicare fee-for-service enrollment

Enrolled in IL

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

Illinois College of Optometry at Chicago, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.19 of 100Reported as individual

Quality

62.39

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Haley Nicole Rambo, OD

  • Optometrist
  • Salem, IL
  • NPI 1720716186
  Medicare reassignment
• R. Scott Wooley

  • Optometrist
  • Flora, IL
  • NPI 1477563773
  Medicare reassignment

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.

• Talley Medical-Surgical Eye Care Associates PC

  dba Talley Eye Institute

  • Ophthalmology Physician
  • Evansville, IN
  • NPI 1154319143

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235088000000",
    "number": "1750479457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628370506",
            "telephone_number": "618-842-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E DELAWARE ST",
            "address_2": "SUITE C",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628372111",
            "telephone_number": "618-842-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUDER",
        "first_name": "PAUL",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009085",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois Primary Care Associates, P.C.
• Southern Illinois Surgical Care Associates, P.C.
• Speech 4 Kids, P.C.
• Mason Spitzner, CRNA
• Kayla R Stanley
• Dylan Wayne Stennett, NP
• Misty D Stone, APN FNP
• Elizabeth M Sweet-Friend, M.D.
• T (Reflection)
• Ashten Taylor, LPN

• Optometrist in Fairfield, IL
• Providers in Fairfield, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.