Individual provider Active NPI

Kimberly McLean, O.D.

  • Optometrist
  • Irving, TX
National Provider Identifier
1033249263
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6089TG Issued in TX
Practice address
3341 Regent Blvd Ste 120
Irving, TX 75063-3131
Phone
(972) 910-8829
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 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 6089TG TX Primary

Addresses

Primary practice location

3341 Regent Blvd Ste 120
Irving, TX 75063-3131

Mailing address

3341 Regent Blvd Ste 120
Irving, TX 75063-3131
Phone (972) 910-8829

Other practice location 1

5706 E Mockingbird Ln Ste 190
Dallas, TX 75206-5421
Phone (214) 987-9583

Other names 1

  • Kim McLean Other name

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
I20140909001432 TX Practitioner - Optometry 2264651041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Paul G. Hayter, O.D., P.C.Group PAC ID 6608891858, 2 clinicians

Practice addresses (Care Compare)

3341 Regent Blvd
Suite 120
Irving, TX 75063-3100

3341 Regent Blvd
Suite 120
Irving, TX 75063-3131
Phone (972) 910-8829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6089TXMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul G. Hayter, O.D., P.C. Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Mai Nguyen OD PLLC Optometrist CurrentSince Feb 26, 2021 Accepting new patients
Anthony Chapman OD, PA Optometrist PastSince Jun 22, 2016 Accepting new patients

Locations

6243 Retail Rd
Ste 800
Dallas, TX 75231
Phone (214) 750-4261

6243 Retail Rd
#800B
Dallas, TX 75231
Phone (214) 890-9864

3341 Regent Blvd
Ste 120
Irving, TX 75063
Phone (972) 910-8829

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1033249263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3341 REGENT BLVD STE 120",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633131",
            "telephone_number": "972-910-8829",
            "fax_number": "972-910-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3341 REGENT BLVD STE 120",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633131",
            "telephone_number": "972-910-8829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5706 E Mockingbird Ln Ste 190",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752065421",
            "country_code": "US",
            "telephone_number": "214-987-9583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6089TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "MCLEAN",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.