Desoto Vision Care Llc is a medicare enrolled "Eyewear Supplier" provider in De Soto, Missouri. Their current practice location is
126 S Main St, De Soto, Missouri. You can reach out to their office (for appointments etc.) via phone at
(636) 586-5406.
Desoto Vision Care Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Desoto Vision Care Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1356161509.
Healthcare Provider's Profile
| Full Name | Desoto Vision Care Llc |
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| Type | Facility |
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| Speciality | Eyewear Supplier |
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| Location | 126 S Main St, De Soto, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1356161509
- Provider Enumeration Date: 10/14/2024
- Last Update Date: 11/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 3971039447
- Enrollment ID: O20241206001680
Medical Identifiers
Medical identifiers for Desoto Vision Care Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1356161509 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Desoto Vision Care Llc acts as a billing entity for following providers:
| Provider Name | Charles William Pelton |
|---|
| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1962767665 PECOS PAC ID: 0143470146 Enrollment ID: I20121029000649 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Desoto Vision Care Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Desoto Vision Care Llc 126 S Main St, De Soto, MO 63020-2104 Ph: (636) 586-5406 | Desoto Vision Care Llc 126 S Main St, De Soto, MO 63020-2104 Ph: (636) 586-5406 |
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