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DR. GARY HOUSTON ST. CLAIR O.D.
NPI 1548274657
Optometrist in Lynchburg, VA

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment
20838A TIMBERLAKE RD, LYNCHBURG, VA 24502(434) 239-2800(434) 237-7037 Get Directions Write a Review

NPPES record last updated: November 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 23, 2016, Sep 27, 2016 (2 updates tracked since 2016).

About Dr. Gary Houston St. Clair O.d. NPPES

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

DR. GARY HOUSTON ST. CLAIR O.D. (NPI 1548274657) is an individual optometrist in Lynchburg, Virginia, licensed in Virginia (0618000448) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Southern College Of Optometry (1980).

NPPES Registry Identity

NPI1548274657
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. GARY HOUSTON ST. CLAIRCredential: O.D.
Location Address20838A TIMBERLAKE RDLynchburg, VA 24502-7241
Mailing Address20838 Timberlake Rd, Ste ALynchburg, VA 24502-7241 · (434) 239-2800 · Fax (434) 237-7037
Phone(434) 239-2800
Fax(434) 237-7037
Sole ProprietorYes
Medical School CMSSouthern College Of OptometryGraduated 1980
Enumeration DateJuly 27, 2006
Last NPPES UpdateNovember 23, 20162 updates tracked since enumeration
✔ NPI 1548274657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in VA · 0618000448
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.
20838A TIMBERLAKE RD, Lynchburg, VA 24502
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Other Identifiers 3

Medicare PIN410000427VA
Medicaid009204555VA
Medicare UPINT87772VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gary Houston St. Clair O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082781307
PECOS Enrollment IDI20111011000344
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
97 services97 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
51 services36 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
20 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24502 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%51 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS ROZELLE O.D.
Optometrist
20838A TIMBERLAKE RD
LYNCHBURG, VA 24502
Lynchburg City (434) 239-2800
MYEYEDR OPTOMETRY OF VIRGINIA, PLLC
Optometrist
20838A TIMBERLAKE RD
LYNCHBURG, VA 24502
Lynchburg City (434) 239-2800
ROBIN MCCLENNY AYERS OD
Optometrist
20838A TIMBERLAKE RD
LYNCHBURG, VA 24502
Lynchburg City (434) 239-2800

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 Gary St. Clair's NPI number?

The NPI number for Gary St. Clair is 1548274657. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Gary St. Clair located?

Gary St. Clair practices at 20838A Timberlake Rd, Lynchburg, VA 24502. The listed phone number is (434) 239-2800.

What is Gary St. Clair's specialty?

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

Is Gary St. Clair enrolled in Medicare?

Yes. Gary St. Clair is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gary St. Clair accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Gary St. Clair 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 Gary St. Clair was last updated on November 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.