Individual provider Active NPI

Kraig Michael Stasney, O.D.

  • Optometrist
  • Picayune, MS
National Provider Identifier
1861598765
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
611 Issued in MS
Practice address
718 Highway 11 S Ste B
Picayune, MS 39466-5310
Phone
(601) 799-0707
Fax
(601) 799-0700
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Eyecare, LLC 4 clinicians

Practice addresses (Care Compare)

5 Alex PL
Picayune, MS 39466-9697
Phone (601) 799-0707

64185 Hwy 41
Suite B
Pearl River, LA 70452-3673
Phone (985) 250-8000

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as group
Quality
79.75
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060131000419 MS Practitioner - Optometry 2961416078 Reassigns benefits to 1 organization
I20141205001854 LA Practitioner - Optometry 2961416078 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
611MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare, LLC Optometrist CurrentSince Jun 9, 2005 Accepting new patients

Locations

64185 Highway 41
Pearl River, LA 70452

64185 Highway 41
Ste B
Pearl River, LA 70452
Phone (985) 250-8000

5 Alex Pl
Ste B
Picayune, MS 39466

5 Alex Pl
Picayune, MS 39466
Phone (601) 799-0707

718 Highway 11 S
#B
Picayune, MS 39466
Phone (601) 799-0707

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 611 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

718 Highway 11 S Ste B
Picayune, MS 39466-5310

Mailing address

718 Highway 11 S Ste B
Picayune, MS 39466-5310
Phone (601) 799-0707

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
00880072MedicaidMS
753195132OtherMSTAX ID

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 18, 2010.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1861598765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 HIGHWAY 11 S STE B",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665310",
            "telephone_number": "601-799-0707",
            "fax_number": "601-799-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 HIGHWAY 11 S STE B",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665310",
            "telephone_number": "601-799-0707",
            "fax_number": "601-799-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASNEY",
        "first_name": "KRAIG",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880072",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "753195132",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Picayune, MS

Sources for this page

Verify at the official NPI Registry.