Individual provider Active NPI

J Richard Levy, O.D.

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1760412399
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO2191 Issued in MO
Practice address
5 Bellerosa CT
Saint Louis, MO 63122-3358
Phone
(314) 821-2925
Fax
(314) 821-2991
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO2191 MO Primary

Addresses

Primary practice location

5 Bellerosa CT
Saint Louis, MO 63122-3358

Mailing address

5 Bellerosa CT
Saint Louis, MO 63122-3358
Phone (314) 821-2925

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
I20061116000367 MO Practitioner - Optometry 4880692375 Reassigns benefits to 1 organization
Practice locations: St Louis, MO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO2191MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Eye, Inc. Optometrist CurrentSince Jan 26, 2021 Accepting new patients

Locations

9717 Clayton Rd
Saint Louis, MO 63124
Phone (314) 997-0002

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760412399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BELLEROSA CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223358",
            "telephone_number": "314-821-2925",
            "fax_number": "314-821-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BELLEROSA CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223358",
            "telephone_number": "314-821-2925",
            "fax_number": "314-821-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "J",
        "middle_name": "RICHARD",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.