Surevision Eye Centers Midwest Llc is a medicare enrolled "Ophthalmology" provider in Creve Coeur, Missouri. Their current practice location is
12101 Woodcrest Executive Dr Ste 150, Creve Coeur, Missouri. You can reach out to their office (for appointments etc.) via phone at
(314) 921-2020.
Surevision Eye Centers Midwest Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Surevision Eye Centers Midwest 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 1699857912.
Healthcare Provider's Profile
| Full Name | Surevision Eye Centers Midwest Llc |
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| Type | Facility |
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| Speciality | Ophthalmology |
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| Location | 12101 Woodcrest Executive Dr Ste 150, Creve Coeur, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699857912
- Provider Enumeration Date: 10/19/2006
- Last Update Date: 09/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 1850297904
- Enrollment ID: O20031209001023
Medical Identifiers
Medical identifiers for Surevision Eye Centers Midwest Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1699857912 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (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.
Surevision Eye Centers Midwest Llc acts as a billing entity for following providers:
| Provider Name | Lawrence A Gans |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1396748000
PECOS PAC ID: 2062318165
Enrollment ID: I20041120000160 |
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| Provider Name | Tonya Bourn |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1851340152
PECOS PAC ID: 8527017664
Enrollment ID: I20050117000088 |
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| Provider Name | Jessica Lynn Weis |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1205406766
PECOS PAC ID: 1153724216
Enrollment ID: I20210813002782 |
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| Provider Name | Matthew Kyle Mccoy |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1043835580
PECOS PAC ID: 5294157509
Enrollment ID: I20220610002194 |
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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. Surevision Eye Centers Midwest 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 |
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Surevision Eye Centers Midwest Llc
320 Brookes Dr, Suite 111,
Hazelwood, MO 63042-2736
Ph: (314) 726-5669 | Surevision Eye Centers Midwest Llc
12101 Woodcrest Executive Dr Ste 150,
Creve Coeur, MO 63141-5050
Ph: (314) 921-2020 |
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