Organization Active NPI

Optical Expressions LLC

  • Optometrist
  • St Louis, MO
National Provider Identifier
1932374741
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
M0T03318 Issued in MO
Legal business name
OPTICAL EXPRESSIONS LLC
Practice address
12422 Olive Blvd
St Louis, MO 63141-6392
Phone
(314) 579-0909
Fax
(314) 514-7413
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Authorized official

Name
Dr. Thomas J Cullinane, ODNPI 1669546354
Title
President
Phone
(314) 579-0909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X T3318 MO
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X M0T03318 MO Primary

Addresses

Primary practice location

12422 Olive Blvd
St Louis, MO 63141-6392

Mailing address

12422 Olive Blvd
St Louis, MO 63141-6392
Phone (314) 579-0909

Other names 1

  • Optical Expressions Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081113000709 MO Part B Supplier - Clinic/Group Practice 5597825042 Receives reassigned benefits from 4 practitioners
Practice locations: Clayton, MO; Creve Coeur, MO
O20100930078381 MO DME Supplier - Physician - OptometristDME Supplier - Optician 5597825042 Practice locations: Saint Louis, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Optical Expressions LLC12422 Olive Blvd, Saint Louis, MO 63141-6392(314) 579-0909 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory

Locations

7718 Forsyth Blvd
Clayton, MO 63105
Phone (314) 721-0909

12619 Olive Blvd
Saint Louis, MO 63141
Phone (314) 579-0909

12422 Olive Blvd
Saint Louis, MO 63141
Phone (314) 579-0909

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1932374741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12422 OLIVE BLVD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631416392",
            "telephone_number": "314-579-0909",
            "fax_number": "314-514-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12422 OLIVE BLVD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631416392",
            "telephone_number": "314-579-0909",
            "fax_number": "314-514-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL EXPRESSIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "CULLINANE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-579-0909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T3318",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "M0T03318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optical Expressions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.