Active NPI
Sue E Young Knolle, M.D.
- Ophthalmology Physician
- Austin, TX
National Provider Identifier
1043213721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- D6220
- Practice address
- 515 S Capital of Texas Hwy
Ste 100
Austin, TX 78746-4305 - Phone
- (512) 472-4011
- Fax
- (512) 472-5057
- NPI assigned
- May 24, 2005
- Reactivated
- Mar 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | D6220 | TX | Primary |
Addresses
Primary practice location
515 S Capital of Texas Hwy
Ste 100
Austin, TX 78746-4305
Mailing address
515 S Capital of Texas Hwy
Ste 100
Austin, TX 78746-4305
Phone (512) 472-4011
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZOOOL63V8 | Medicaid | TX | MEDICAID NUMBER |
| 1043213721 | Other | TX | NPI |
| 1154432508 | Other | TX | GROUP NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6220 | TX | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knolle & Young Associates PA | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Westlake Eye Specialists
- Ophthalmology Physician
- West Lake Hills, TX
- NPI 1154432508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1043213721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 S CAPITAL OF TEXAS HWY",
"address_2": "STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787464305",
"telephone_number": "512-472-4011",
"fax_number": "512-472-5057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 S CAPITAL OF TEXAS HWY",
"address_2": "STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787464305",
"telephone_number": "512-472-4011",
"fax_number": "512-472-5057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG KNOLLE",
"first_name": "SUE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-24",
"last_updated": "2007-11-06",
"deactivation_date": "2006-03-17",
"reactivation_date": "2006-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "D6220",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": "MEDICAID NUMBER",
"identifier": "ZOOOL63V8",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1043213721",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1154432508",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.