Douglas P Nosacka, O.D.
Individual provider Active NPI Optometrist · Malden, MO
NPI 1760614598 · NPPES record last updated Dec 12, 2016
Key facts
- NPI
- 1760614598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2011030374 (MO)
- Practice address
- 1122 N Douglass St
Malden, MO 63863-1342 - Phone
- (573) 276-3239
- NPI assigned
- Aug 12, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- International American University at Puerto Rico - School of Optometry, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hunt and Nosacka Optometric Group PC
Practice addresses (Care Compare)
1122 N Douglass St
Semo Vision Care
Malden, MO 63863-1342
Phone (573) 276-3239
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 15 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120423000658 | MO | Practitioner - Optometry | 4587789805 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionary Optometrics, LLC | Optometrist | Current |
Accepting new patients |
| Hunt & Nosacka Optometric Group P.C. | Optometrist | Current |
Accepting new patients |
| Jason Wonch, O.D. and Associates, a.P.C. | Optometrist | Past | Accepting new patients |
Locations
1122 N Douglass St
Malden, MO 63863
Phone (573) 276-3239
Interoperability endpoints
- dpnosacka@semovisioncare.eyefinity-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2011030374 | MO | Yes |
Addresses
Primary practice location
1122 N Douglass St
Malden, MO 63863-1342
Mailing address
1122 N Douglass St
Malden, MO 63863-1342
Phone (573) 276-3239
Other providers in Malden, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.