Cassidy Obermark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2013021015 Issued in MO

Practice address

1250 N Main St
Sikeston, MO 63801-4827

Phone

(573) 471-1080

Fax

(573) 471-1810

NPI assigned

Jul 25, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

University of Missouri St Louis - School of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr. Daniel R. Obermark Optometry PCGroup PAC ID 0648359349, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Dr. Daniel R. Obermark Optometry PC

  • Optometrist
  • Poplar Bluff, MO
  • NPI 1205007614
  Medicare reassignment Care Compare group NPD
• Eye Surgery Consultants LLC

  • Ophthalmology Physician
  • Poplar Bluff, MO
  • NPI 1316553373

  Optometrist

  Medicare reassignment NPD
• Northeastern State University College of Optometry

  • Optometrist
  • Tahlequah, OK
  • NPI 1437106333
  NPD (past)

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1841546074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014827",
            "telephone_number": "573-471-1080",
            "fax_number": "573-471-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014827",
            "telephone_number": "573-471-1080",
            "fax_number": "573-471-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERMARK",
        "first_name": "CASSIDY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2743",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2013021015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Nichols, DPT, ATC, CSCS
• Jennifer A Nickell, MD
• Brenda J. Nicolai, PT, MHS, OCS
• Jacqueline Nielson, LCSW
• Molly K Nirider, OTR/L
• Daniel Robert Obermark, O.D.
• Opulent Care Adult Daycare Center, LLC
• Jennifer L Owens, LCSW
• Wilson Prakash Pais, MD
• Rachael M Parker, DMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.