Individual provider Active NPI

Jennifer Thai, OD

  • Optometrist
  • Austin, TX
National Provider Identifier
1013438464
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9216T Issued in TX
Practice address
4301 W William Cannon Dr Ste 210
Austin, TX 78749-1473
Phone
(512) 328-0015
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9216T TX Primary

Addresses

Primary practice location

4301 W William Cannon Dr Ste 210
Austin, TX 78749-1473

Mailing address

4301 W William Cannon Dr Ste 210
Austin, TX 78749-1473
Phone (512) 328-0015

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
I20171019001693 TX Practitioner - Optometry 4880960848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Signature Eye Care, P.a.Group PAC ID 0244365799, 7 clinicians

Practice addresses (Care Compare)

2071 Cypress Creek Rd
Cedar Park, TX 78613-3622
Phone (512) 250-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9216TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Eye Care, P.a. Optometrist CurrentSince May 17, 2022 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Sep 7, 2021 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Feb 23, 2025 Accepting new patients

Locations

4301 W William Cannon Dr
Ste B210
Austin, TX 78749
Phone (512) 328-0015

4301 W William Cannon Dr
Ste 210
Austin, TX 78749
Phone (512) 328-0015

3908 Far West Blvd
Austin, TX 78731
Phone (512) 343-0432

2071 Cypress Creek Rd
Cedar Park, TX 78613
Phone (512) 250-1700

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013438464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W WILLIAM CANNON DR STE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491473",
            "telephone_number": "512-328-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W WILLIAM CANNON DR STE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491473",
            "telephone_number": "512-328-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAI",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9216T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.