NPIMap

Individual provider Active NPI

Clarence Tucker Joustra, DO

  • Family Medicine Physician
  • Lamar, MO
National Provider Identifier
1942202080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9G86 Issued in MO
Practice address
805 Gulf St
Lamar, MO 64759-1238
Phone
(417) 682-5508
Fax
(417) 682-5594
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R9G86 MO Primary

Addresses

Primary practice location

805 Gulf St
Lamar, MO 64759-1238

Mailing address

805 Gulf St
Lamar, MO 64759-1238
Phone (417) 682-5508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100301000424 MO Practitioner - Family Practice 5193782472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

805 Gulf St
Lamar, MO 64759-1238
Phone (417) 682-5508

Hospital & facility affiliations

  • Amedisys Home Health of Missouri Home health agency, Joplin, MO, CCN 267606
  • Integrity Home Care + Hospice Home health agency, Springfield, MO, CCN 267576
  • Cox Barton County Hospital Hospital, Lamar, MO, CCN 261325
  • Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137
  • Mercy Hospital Carthage Hospital, Carthage, MO, CCN 261338
  • Nevada Regional Medical Center Hospital, Nevada, MO, CCN 260061

Merit-based Incentive Payment System (MIPS)

Final score
29.05 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
70.92

Merit-based Incentive Payment System (MIPS)

Final score
74.07 of 100Reported as group
Quality
45.41
Promoting interoperability
97
Improvement activities
40
Cost
70.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions15
Removal of nail tissue15
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
C. Tucker Joustra Family Practice, Inc. CurrentSince Jul 1, 1998 Accepting new patients
Lamar No 1 Inc Past Accepting new patients

Locations

805 Gulf St
Lamar, MO 64759
Phone (417) 682-5508

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Truman Healthcare & Rehabilitation CenterLamar, MO, CCN 265253 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 1992
Jan 1, 1992

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942202080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 GULF ST",
            "city": "LAMAR",
            "state": "MO",
            "postal_code": "647591238",
            "telephone_number": "417-682-5508",
            "fax_number": "417-682-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 GULF ST",
            "city": "LAMAR",
            "state": "MO",
            "postal_code": "647591238",
            "telephone_number": "417-682-5508",
            "fax_number": "417-682-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUSTRA",
        "first_name": "CLARENCE",
        "middle_name": "TUCKER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9G86",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lamar, MO

Sources for this page

Verify at the official NPI Registry.