James J Altenbernd, O.D.
Individual provider Active NPI Optometrist · Saint Louis, MO
NPI 1770535965 · NPPES record last updated Mar 20, 2008
Key facts
- NPI
- 1770535965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- DO2917 (MO)
- Practice address
- 4512 Lemay Ferry Rd
Saint Louis, MO 63129-1614 - Phone
- (314) 845-6410
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3270 Telegraph Rd
Saint Louis, MO 63125-5565
Phone (314) 845-3164
3543 Yaeger Crossing CT
Saint Louis, MO 63129-2369
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 |
|---|---|---|---|---|
| I20060802000372 | MO | Practitioner - Optometry | 0749293041 | Practice locations: Saint Louis, MO |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO2917 | MO | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | DO2917 | MO | Yes |
Addresses
Primary practice location
4512 Lemay Ferry Rd
Saint Louis, MO 63129-1614
Mailing address
3549 Yaeger Crossing CT
Saint Louis, MO 63129-2369
Phone (314) 487-8651
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2008. 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.