Scott Dale Staatz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO3394 Issued in MO

Practice address

2707 Miller St
Bethany, MO 64424-2704

Phone

(660) 425-8116

Fax

(660) 425-3418

NPI assigned

Jul 27, 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

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethany Eye Center, LLCGroup PAC ID 1153397005, 2 clinicians

Viking Vision IncGroup PAC ID 6103161120, 4 clinicians

Nass, IncGroup PAC ID 3476528845, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bethany Eye Center, LLC

  • Optometrist
  • Bethany, MO
  • NPI 1245278753
  Medicare reassignment Care Compare group NPD
• Nass, Inc

  dba The Eye Center of Parkville

  • Optometrist
  • Parkville, MO
  • NPI 1609823384
  Medicare reassignment Care Compare group NPD
• Viking Vision, Inc.

  dba In Vision Eye Care Center Gladstone

  • Optometrist
  • Gladstone, MO
  • NPI 1306316914
  Medicare reassignment Care Compare group
• Moyes Eye Center, P.C.

  • Specialist
  • Kansas City, MO
  • NPI 1700826229
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801810189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 MILLER ST",
            "city": "BETHANY",
            "state": "MO",
            "postal_code": "644242704",
            "telephone_number": "660-425-8116",
            "fax_number": "660-425-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 MILLER ST",
            "city": "BETHANY",
            "state": "MO",
            "postal_code": "644242704",
            "telephone_number": "660-425-8116",
            "fax_number": "660-425-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAATZ",
        "first_name": "SCOTT",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth W Shewell, MD
• Emily Kaylene Shuck
• Patricia Slaughter, LMSW
• Solutions for Families, Inc.
• St Joseph Specialty Clinic PC
• Coy Stephens, DPT
• Madison Nicole Stephens, DPT
• Kimberly D Strain, CPT
• Kathy Sweat, RPH
• Ayongwi A Tazuh, PHARMACIST

• Optometrist in Bethany, MO
• Providers in Bethany, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.