Individual provider Active NPI

Maria Quintanilla, O.D.

  • Optometrist
  • Taylor, TX
National Provider Identifier
1003881574
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05312TG Issued in TX
Practice address
3701 N Main St
Ste a
Taylor, TX 76574-4975
Phone
(512) 352-1600
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 05312TG TX Primary

Addresses

Primary practice location

3701 N Main St
Ste a
Taylor, TX 76574-4975

Mailing address

2953 Desert Candle Dr
Round Rock, TX 78681-2453
Phone (512) 352-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000460 TX Practitioner - Optometry 5193739225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brett W Hamilton OD PAGroup PAC ID 3476693425, 3 clinicians

Practice addresses (Care Compare)

481 Sundance Pkwy
Suite 100
Round Rock, TX 78681-2079
Phone (512) 255-9995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05312TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brett W Hamilton OD PA Optometrist CurrentSince Jul 8, 2017 Accepting new patients
Brett W Hamilton OD Optometrist PastSince Jul 8, 2017 Accepting new patients
Freedom Eye Care PLLC Optometrist PastSince Jun 15, 2012 Accepting new patients

Locations

481 Sundance Pkwy
Round Rock, TX 78681
Phone (512) 545-2331

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1003881574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2953 DESERT CANDLE DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786812453",
            "telephone_number": "512-352-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 N MAIN ST",
            "address_2": "STE A",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765744975",
            "telephone_number": "512-352-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANILLA",
        "first_name": "MARIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05312TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, TX

Sources for this page

Verify at the official NPI Registry.