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DR. STEPHEN VINCENT CUSUMANO O.D.
NPI 1831192533
Optometrist in O Fallon, MO

Active since May 27, 2005PECOS EnrolledAccepts Medicare Assignment
2681 HIGHWAY K, O FALLON, MO 63368(636) 978-5555(636) 978-5555 Get Directions Write a Review

NPPES record last updated: October 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Stephen Vincent Cusumano O.d. NPPES

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

DR. STEPHEN VINCENT CUSUMANO O.D. (NPI 1831192533) is an individual optometrist in O Fallon, Missouri, licensed in Missouri (TO2670) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Saint Charles, and is a graduate of University Of Missouri St Louis - School Of Optometry (1986).

NPPES Registry Identity

NPI1831192533
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. STEPHEN VINCENT CUSUMANOCredential: O.D.
Location Address2681 HIGHWAY KO Fallon, MO 63368-7865
Mailing Address9979 Winghaven Blvd Ste 210O Fallon, MO 63368-3628 · (636) 695-8555 · Fax (636) 695-8555
Phone(636) 978-5555
Fax(636) 978-5555
Sole ProprietorNo
Medical School CMSUniversity Of Missouri St Louis - School Of OptometryGraduated 1986
Enumeration DateMay 27, 2005
Last NPPES UpdateOctober 20, 2025
NPPES CertifiedOctober 20, 2025
✔ NPI 1831192533 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 MO · TO2670
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.
2681 HIGHWAY K, O Fallon, MO 63368
Open in Google Maps ↗

Secondary Practice Location 1

Location 13758 Elm StSaint Charles, MO 63301-4336 · Phone (636) 757-3553 · Fax (636) 757-3553

Other Identifiers 3

Other91710001Ptan
Other1831192533Npi
Other431081796MO · Federal Tax Id

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan 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. Stephen Vincent Cusumano 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 ID143382630
PECOS Enrollment IDI20081217000306
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 6

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 office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
112 services112 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.
30 services21 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
15 services15 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
14 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients
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.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63368 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
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
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.

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. EMMA M SCHAFERS-KARL O.D.
Optometrist
2681 HIGHWAY K
O FALLON, MO 63368
St. Charles County (636) 978-5555
DR. JEFFREY JAMES LANT O.D.
Optometrist
2681 HIGHWAY K
O FALLON, MO 63368
St. Charles County (636) 978-5555
DR. LISA MARIE MACKEY OD
Optometrist
2681 HIGHWAY K
O FALLON, MO 63368
St. Charles County (636) 978-5555

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 Stephen Cusumano's NPI number?

The NPI number for Stephen Cusumano is 1831192533. It was assigned to this individual provider in the NPPES registry on May 27, 2005.

Where is Stephen Cusumano located?

Stephen Cusumano practices at 2681 Highway K, O Fallon, MO 63368. The listed phone number is (636) 978-5555.

What is Stephen Cusumano's specialty?

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

Is Stephen Cusumano enrolled in Medicare?

Yes. Stephen Cusumano 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 Stephen Cusumano accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 11 other insurers list Stephen Cusumano 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 Stephen Cusumano was last updated on October 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.