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REJUVENATE LIGHT AND VISION CENTER
NPI 1366396889
Optometrist in Nixa, MO

Active since February 23, 2026
220 N MASSEY BLVD, NIXA, MO 65714(417) 374-1088 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Rejuvenate Light And Vision Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REJUVENATE LIGHT AND VISION CENTER (NPI 1366396889) is a healthcare organization registered as an optometrist in Nixa, Missouri and active in the NPI registry since February 2026. The organization lists Cade John Kowallis, Owner, as its authorized official.

NPPES Registry Identity

NPI1366396889
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameREJUVENATE LIGHT AND VISION CENTER
Location Address220 N MASSEY BLVDNixa, MO 65714-8324
Mailing Address220 N Massey BlvdNixa, MO 65714-8324 · (417) 374-1088
Phone(417) 374-1088
Organization SubpartNo
Authorized OfficialCade John KowallisOwner · (417) 604-0188
Enumeration DateFebruary 23, 2026
Last NPPES UpdateMarch 24, 2026
NPPES CertifiedMarch 24, 2026
✔ NPI 1366396889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
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.
Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X
Also ListedOptometrist · PediatricsTaxonomy 152WP0200X
Also ListedOptometrist · Vision TherapyTaxonomy 152WV0400X
220 N MASSEY BLVD, Nixa, MO 65714
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rejuvenate Light And Vision Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Rejuvenate Light And Vision Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

Cade Kowallis, O.D.
Optometry
NPI 1952781262
220 N MASSEY BLVD
Nixa, MO 65714
(417) 604-0188
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rejuvenate Light And Vision Center's NPI number?

The NPI number for Rejuvenate Light And Vision Center is 1366396889. It was assigned to this organization in the NPPES registry on February 23, 2026.

Where is Rejuvenate Light And Vision Center located?

Rejuvenate Light And Vision Center is located at 220 N Massey Blvd, Nixa, MO 65714. The listed phone number is (417) 374-1088.

What is Rejuvenate Light And Vision Center's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Rejuvenate Light And Vision Center enrolled in Medicare?

Yes. Rejuvenate Light And Vision Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Rejuvenate Light And Vision Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Rejuvenate Light And Vision Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Rejuvenate Light And Vision Center accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Rejuvenate Light And Vision Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rejuvenate Light And Vision Center was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.