Alexandra Marie Samuelson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2021020008 Issued in MO

Practice address

670 S Commercial St
Harrisonville, MO 64701-1653

Phone

(816) 478-1230

NPI assigned

Jun 19, 2017

Last updated

Sep 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS, MO2 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

Specialty

Optometry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care LLCGroup PAC ID 4385544600, shared by 2 NPIs, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asamuelson@direct.dvc.nextgenshare.com

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.

• Eye Care, LLC

  dba Discover Vision Centers

  • Ophthalmology Physician
  • Harrisonville, MO
  • NPI 1609066034

  Optometrist

  Medicare reassignment NPD
• Eye Care, LLC

  dba Discover Vision Centers

  • Optometrist
  • Leawood, KS
  • NPI 1881884211
  Medicare reassignment NPD
• Eye Care LLC

  dba Discover Vision Centers

  • Ophthalmology Physician
  • Independence, MO
  • NPI 1750374567

  Optometrist

  NPD
• Eye Care, LLC

  dba Discover Vision Centers

  • Optometrist
  • Raymore, MO
  • NPI 1023597127
  NPD

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1902336274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S CLIFF AVE STE 100",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556954",
            "telephone_number": "816-478-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 S COMMERCIAL ST",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647011653",
            "telephone_number": "816-478-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9221T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2021020008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00126189",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Sturdevant, DO Pediatric Care, PC
• Allie Rogers
• Kendra Rose, APRN
• Krystin L.G. Ryan, PLPC
• Brandi Jo Samborski, PTA
• Lida Teresa Santiago, LPC
• Lyndee Larson Schaefer, LPC
• Audrey Schaulat
• Nicholle Renae Scheibe
• Amy Christine Schenke, LCSW, LCAC, LSCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.