DR. BRADLEY ELLIOTT BORELLO (NPI# 1225268451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225268451 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY ELLIOTT BORELLO |
| Credential | OD |
| Practice Address |
532 Old Smizer Mill Rd Fenton MO 63026-3538 |
| Mailing Address |
900 Burgundy Ln Ballwin MO 63011-3584 |
| Practice Telephone | 6363057110 |
| Practice Fax Number | 6363059509 |
| Mailing Telephone | 6363057110 |
| Mailing Fax Number | 6363059509 |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2011-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2009016924 | MO | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1225268451 | 05 |
| Street Address |
532 OLD SMIZER MILL RD |
| City | FENTON |
| State | MO |
| Zip Code | 63026-3538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245619873 | Scott Hussey Od LLC | Eyewear Supplier (Equipment, not the service) | 532 Old Smizer Mill Rd, Fenton, MO 63026-3538 | 2015-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
| 1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
| 1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
| 1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
| 1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
| 1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
| 1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
| 1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
| 1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
| 1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
| Find all providers in zip 63026 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881155281 | Iris Eyecare PC | Optometrist | 403 S Leroy St, Fenton, MI 48430-2143 | 2019-03-28 |
| 1609223619 | Juan Alvarado Od Pllc | Optometrist | 212 W Silver Lake Rd, Fenton, MI 48430-2606 | 2016-05-19 |
| 1003223561 | Jamie Lynn Pancy | Optometrist | 3140 W Silver Lake Rd, Fenton, MI 48430-1321 | 2014-07-16 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1548566862 | E Doran Kasper Od PC | Optometrist | 234 W. Caroline St., Fenton, MI 48430-2807 | 2011-02-03 |
| 1295868602 | Mac Optical | Optometrist | 1425 N Leroy St, Fenton, MI 48430-2763 | 2007-03-14 |
| 1013046259 | James Charles Reeves | Optometrist | 521 N Leroy St, Fenton, MI 48430-2733 | 2007-03-05 |
| 1689754350 | Juan Alvarado | Optometrist | 1535 N Leroy St, Fenton, MI 48430-2791 | 2006-10-17 |
| 1134214216 | Daniel Gerard Puetz | Optometrist | 920 Brookwood Ctr, Fenton, MO 63026-3474 | 2006-10-04 |
| 1962432237 | Scott T Hussey | Optometrist | 480 Old Smizer Mill Rd, Fenton, MO 63026-3553 | 2006-07-03 |
| Find all providers in FENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.