Individual provider Active NPI

Douglas Scott Kirar, OD

  • Optometrist
  • Bolirar, MO
National Provider Identifier
1982709697
Registry record updated Aug 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MO2003025605 Issued in MO
Practice address
2451 S Springfield Ave
Wal-Mart Vision Center #0046
Bolirar, MO 65613
Phone
(417) 777-7662
Fax
(417) 777-6917
NPI assigned
Sep 14, 2006
Last updated
Aug 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MO2003025605 MO Primary

Addresses

Primary practice location

2451 S Springfield Ave
Wal-Mart Vision Center #0046
Bolirar, MO 65613

Mailing address

508 E Petty Lane
Stockton, MO 65785
Phone (417) 276-6254

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
I20040123000168 MO Practitioner - Optometry 5698677326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bolivar Vision, LLCGroup PAC ID 6608190152, 4 clinicians
El Dorado Vision LLCGroup PAC ID 0547501041, 2 clinicians

Practice addresses (Care Compare)

680 E Aldrich Rd
Bolivar, MO 65613-2573
Phone (417) 777-9000

701 E Hospital Rd
El Dorado Springs, MO 64744-2316
Phone (417) 876-6052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MO2003025605MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bolivar Vision, LLC Optometrist CurrentSince Jul 1, 2020 Accepting new patients
El Dorado Vision LLC Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Missouri Eye Institute LLC Optometrist PastSince Jul 1, 2020 Accepting new patients

Locations

680 E Aldrich Rd
Bolivar, MO 65613
Phone (417) 777-9000

701 E Hospital Rd
El Dorado Springs, MO 64744
Phone (417) 876-6052

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376784000000",
    "number": "1982709697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 E PETTY LANE",
            "city": "STOCKTON",
            "state": "MO",
            "postal_code": "65785",
            "telephone_number": "417-276-6254",
            "fax_number": "417-777-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 S SPRINGFIELD AVE",
            "address_2": "WAL-MART VISION CENTER #0046",
            "city": "BOLIRAR",
            "state": "MO",
            "postal_code": "65613",
            "telephone_number": "417-777-7662",
            "fax_number": "417-777-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRAR",
        "first_name": "DOUGLAS",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "MO2003025605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.