Individual provider Active NPI

Roberta J Crawford, O.D.

  • Optometrist
  • Crystal City, MO
National Provider Identifier
1871689349
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO3244 Issued in MO
Practice address
400 S Truman Blvd
Crystal City, MO 63019-1726
Phone
(636) 933-6020
Fax
(636) 933-6420
NPI assigned
Oct 4, 2006
Last updated
Oct 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO3244 MO Primary

Addresses

Primary practice location

400 S Truman Blvd
Crystal City, MO 63019-1726

Mailing address

400 S Truman Blvd
Crystal City, MO 63019
Phone (636) 933-6020

Other identifiers 1

IdentifierTypeStateIssuer
314639113MedicaidMO

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101109000743 MO Practitioner - Optometry 5597973917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmology Consultants LLCGroup PAC ID 6800884008, 22 clinicians

Practice addresses (Care Compare)

12990 Manchester Rd
Saint Louis, MO 63131-1860

7331 Watson Rd
Galanis Cataract and Laser Center
Saint Louis, MO 63119-4405
Phone (314) 633-8575

Merit-based Incentive Payment System (MIPS)

Final score
79.58 of 100Reported as group
Quality
80.09
Promoting interoperability
88
Improvement activities
40
Cost
61.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO3244MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmology Consultants, LLC Optometrist CurrentSince Sep 23, 2019 Accepting new patients
Ophthalmology Consultants, LLC CurrentSince Sep 23, 2019 Accepting new patients
Day Optometry, Inc. Past Accepting new patients
Family Vision Associates, LLC PastSince Jul 1, 2003 Accepting new patients

Locations

12990 Manchester Rd
Ste 201
Saint Louis, MO 63131
Phone (314) 909-0633

621 S New Ballas Rd
Ste 5006B
Saint Louis, MO 63141
Phone (314) 251-5300

7331 Watson Rd
Saint Louis, MO 63119
Phone (314) 633-8575

Interoperability endpoints

  • Direct secure messaging: roberta.crawford.p1@direct.ocltd.nextgenshare.com
  • Direct secure messaging: roberta.crawford.p2@direct.ocltd.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1871689349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S TRUMAN BLVD",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "63019",
            "telephone_number": "636-933-6020",
            "fax_number": "636-933-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S TRUMAN BLVD",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "630191726",
            "telephone_number": "636-933-6020",
            "fax_number": "636-933-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314639113",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal City, MO

Sources for this page

Verify at the official NPI Registry.