DR. IRA NATHAN ETTINGER (O.D.) – Corneal and Contact Management Optometrist, NPI 1659421303

DR. IRA NATHAN ETTINGER (O.D.) is a healthcare provider. based in Ballwin, Missouri. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. T02543 (MO). The NPI Number for DR. IRA NATHAN ETTINGER (O.D.) is 1659421303

Main info

Male
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
DR. IRA NATHAN ETTINGER (O.D.)
NPI
1659421303
Phone
(636) 227-3067
Address
1229 WISSMANN DR
Enumeration Date
12 January 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
24852821166
Graduation Year
1983 (43 years ago)
PAC ID
3779681317
Group Practice PAC ID
7517242746
Professional Enrollment ID
I20070606000162
Address ID
MO631464405SA12758CTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

863 OPTOMETRY in MO

Provider Addresses for DR. IRA NATHAN ETTINGER (O.D.)

  • 1229 WISSMANN DR

    BALLWIN, MO 630114362

    Phone: (636) 227-3067

    Type: Mailing

  • 1701 AROY DR.

    WASHINGTON, MO 63090

    Phone: (636) 390-3285

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-06-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070606000162IOptometryMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92004New patient complete exam of visual system4444$0
View full utilization report →

Insurance plans in this area (ZIP 63011)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517242746View full group profile
NameSpecialtyState
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P H T H A L M O L O G YMO
O P T O M E T R YMO
O P H T H A L M O L O G YMO

Reviews

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Frequently asked questions

What NPI should I save for DR. IRA NATHAN ETTINGER (O.D.)?
Save NPI 1659421303 if you need a stable reference for DR. IRA NATHAN ETTINGER (O.D.).
Is DR. IRA NATHAN ETTINGER (O.D.) currently active in the NPI registry?
CMS-published data lists DR. IRA NATHAN ETTINGER (O.D.) as an active registrant.
Can you summarize DR. IRA NATHAN ETTINGER (O.D.)'s specialty in plain language?
Clinically, the directory lists DR. IRA NATHAN ETTINGER (O.D.) with Corneal and Contact Management Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. IRA NATHAN ETTINGER (O.D.)?
The page summarizes Ballwin, Missouri for DR. IRA NATHAN ETTINGER (O.D.); expand the address list for detail.
What if Ballwin, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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