DR. PHILLIP MARK LUECKENHOFF (O.D.) – Optometrist, NPI 1063862969

DR. PHILLIP MARK LUECKENHOFF (O.D.) is a healthcare provider. based in Overland, Missouri. specializing in Optometrist. They hold the professional credentials O.D.. They hold a License No. 2016020853 (MO). The NPI Number for DR. PHILLIP MARK LUECKENHOFF (O.D.) is 1063862969

Main info

Male
Name
DR. PHILLIP MARK LUECKENHOFF (O.D.)
NPI
1063862969
Phone
(314) 423-3874
Address
2533 WOODSON RD
Enumeration Date
21 June 2016
Last Update Date
21 June 2016
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for DR. PHILLIP MARK LUECKENHOFF (O.D.)

  • 2533, Woodson Road, Overland, Saint Louis County, Missouri, 63114, United States

    OVERLAND, MO 631145436

    Phone: (314) 423-3874

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $99.

Total Amount is formed as General ($99) + Research ($0) + Ownership ($0) = $99.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($82).

Total Amount

$99

General + Research + Ownership

Payments

6

Total payment records

General Amount

$99

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2017-03-29

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
I20170329001507IOptometryMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63114)

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Reviews

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Frequently asked questions

How is DR. PHILLIP MARK LUECKENHOFF (O.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. PHILLIP MARK LUECKENHOFF (O.D.) with NPI 1063862969.
Can I rely on DR. PHILLIP MARK LUECKENHOFF (O.D.) being an active provider?
As of the registry snapshot, DR. PHILLIP MARK LUECKENHOFF (O.D.) is marked active.
What taxonomy line describes DR. PHILLIP MARK LUECKENHOFF (O.D.)?
For research purposes, treat DR. PHILLIP MARK LUECKENHOFF (O.D.) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DR. PHILLIP MARK LUECKENHOFF (O.D.)?
DR. PHILLIP MARK LUECKENHOFF (O.D.)'s geographic hint is Overland, Missouri in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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