Individual provider Active NPI

Scott T Hussey, O.D.

  • Optometrist
  • Fenton, MO
National Provider Identifier
1962432237
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2003014766 Issued in MO
Practice address
480 Old Smizer Mill Rd
Fenton, MO 63026-3553
Phone
(636) 305-7110
Fax
(636) 305-9509
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2003014766 MO Primary

Addresses

Primary practice location

480 Old Smizer Mill Rd
Fenton, MO 63026-3553

Mailing address

480 Old Smizer Mill Rd
Fenton, MO 63026-3553
Phone (636) 305-7110

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
I20070103000212 MO Practitioner - Optometry 3870407802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott Hussey OD LLCGroup PAC ID 0749591907, 2 clinicians

Practice addresses (Care Compare)

480 Old Smizer Mill Rd
Fenton, MO 63026-3553
Phone (636) 305-7110

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003014766MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott Hussey OD LLC Optometrist CurrentSince Jun 1, 2015 Accepting new patients
Dr Daniel Puetz Optometrist PC Optometrist PastSince Jun 1, 2015 Accepting new patients
Central Missouri Vision Center Optometrist PastSince Jul 22, 2011 Accepting new patients

Locations

480 Old Smizer Mill Rd
Fenton, MO 63026
Phone (636) 305-7110

532 Old Smizer Mill Rd
Fenton, MO 63026
Phone (636) 305-7110

532 Old Smizer Mill Rd
Ste 1
Fenton, MO 63026
Phone (636) 639-9422

3441 Technology Dr
Lake Saint Louis, MO 63367
Phone (636) 452-0022

Interoperability endpoints

  • Direct secure messaging: shussey@kirkseyecenter.eyefinity-direct.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1962432237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 OLD SMIZER MILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263553",
            "telephone_number": "636-305-7110",
            "fax_number": "636-305-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 OLD SMIZER MILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263553",
            "telephone_number": "636-305-7110",
            "fax_number": "636-305-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSEY",
        "first_name": "SCOTT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2003014766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.