Individual provider Active NPI

Sameena S Khan, OPTOMETRIST

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1962444760
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO3449 Issued in MO
Practice address
1350 Dougherty Ferry Rd
Saint Louis, MO 63122-2534
Phone
(636) 825-2625
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO3449 MO Primary

Addresses

Primary practice location

1350 Dougherty Ferry Rd
Saint Louis, MO 63122-2534

Mailing address

329 Carr Manor CT
Ballwin, MO 63021-3304
Phone (636) 527-4097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO3449MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nu-Crown, LLC Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1962444760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 CARR MANOR CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630213304",
            "telephone_number": "636-527-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631222534",
            "telephone_number": "636-825-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SAMEENA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.