Individual provider Active NPI

Detlef Sleichter, OD

  • Optometrist
  • Springfield, MO
National Provider Identifier
1780104000
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2022005213 Issued in MO
Practice address
1229 E Seminole St Ste 430
Springfield, MO 65804-2227
Phone
(417) 820-9393
NPI assigned
Jun 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 091373 IA
Optometrist 152W00000X 2022005213 MO Primary

Addresses

Primary practice location

1229 E Seminole St Ste 430
Springfield, MO 65804-2227

Mailing address

1229 E Seminole St Ste 430
Springfield, MO 65804-2227
Phone (417) 820-9393

Other identifiers 2

IdentifierTypeStateIssuer
1469OtherNESTATE LICENSE NUMBER
648OtherNETHERAPEUTIC CERTIFICATION

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
I20220329000886 MO Practitioner - Optometry 5193070746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozarks Resource GroupGroup PAC ID 6002068723, 12 clinicians

Practice addresses (Care Compare)

111 N Main St
Urbana, MO 65767-9152
Phone (417) 993-1002

18614 Jackson St
Hermitage, MO 65668-8204
Phone (417) 745-0103

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
091373IAMDOptometrist
2022005213MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Resource Group CurrentSince Apr 1, 2025 Accepting new patients
Ozarks Resource Group CurrentSince Apr 1, 2025 Accepting new patients
Mercy Hospital Springfield Current Accepting new patients
Mercy Clinic Springfield Communities Optometrist CurrentSince Mar 14, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 14, 2022 Accepting new patients

Locations

18614 Jackson St
Hermitage, MO 65668
Phone (417) 745-0103

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Organizations & group practices 5

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1780104000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST STE 430",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST STE 430",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEICHTER",
        "first_name": "DETLEF",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "091373",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2022005213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "1469",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPEUTIC CERTIFICATION",
            "identifier": "648",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.