Alyssa M Harris, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2018036027 Issued in MO

Practice address

4505 E Greenstreet Cir
Wasilla, AK 99654-8425

Phone

(907) 376-2020

NPI assigned

Jul 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

University of Missouri St Louis - School of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McCullough Eyecare, PCGroup PAC ID 6305992454, 2 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 and National Provider Directory roles.

• McCullough Eyecare, PC

  • Optometrist
  • Festus, MO
  • NPI 1285804286
  Medicare reassignment Care Compare group NPD
• Alaska Center for the Blind and Visually Impaired

  • Optometrist
  • Anchorage, AK
  • NPI 1942383823
  NPD (past)

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1831542414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 WALNUT ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281850",
            "telephone_number": "636-937-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 E GREENSTREET CIR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548425",
            "telephone_number": "907-376-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 W Main St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629591188",
            "country_code": "US",
            "telephone_number": "618-997-5311 x54080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ALYSSA",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2018036027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1671191",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Harle
• Caraann Harper
• Dara Harrel
• Teta Harrell
• Elizabeth Harris-Frias
• Derrick Harris
• Gary Allan Harris
• Sergei Harris, MASSAGE THERAPIST
• Shannon Harris, CDCS
• Lisa L Harrison, MD

• Optometrist in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.