Individual provider Active NPI

Kasey Chan, OD

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1841038601
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA3024 Issued in MD
Practice address
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone
(314) 652-4100
NPI assigned
Jul 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2025000514 MO
Optometrist 152W00000X TA3024 MD Primary

Addresses

Primary practice location

915 N Grand Blvd
Saint Louis, MO 63106-1621

Mailing address

8400 15TH Ave
Hyattsville, MD 20783-2431

Other practice location 1

1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181
Phone (314) 652-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TA3024MDMDOptometrist
2025000514MOMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1841038601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 15TH AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207832431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jefferson Barracks Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631254181",
            "country_code": "US",
            "telephone_number": "314-652-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KASEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-17",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2025000514",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA3024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.