Xijing Xu, O.D.
Individual provider Active NPI Optometrist · Warner Robins, GA
NPI 1043326523 · NPPES record last updated Apr 5, 2024
Key facts
- NPI
- 1043326523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPT001734 (GA)
- Practice address
- 2626 Watson Blvd
Eyeglass World
Warner Robins, GA 31093-2950 - Phone
- (478) 273-6858
- Fax
- (478) 542-5304
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120124000858 | GA | Practitioner - Optometry | 6507033081 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT001734 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| King'S International Inc. | Optometrist | Current |
Accepting new patients |
| National Vision Inc | Optometrist | Current |
Accepting new patients |
Locations
2720 Watson Blvd
Warner Robins, GA 31093
Phone (478) 953-9988
2626 Watson Blvd
Warner Robins, GA 31093
Phone (478) 273-6858
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT001734 | GA | Yes |
Addresses
Primary practice location
2626 Watson Blvd
Eyeglass World
Warner Robins, GA 31093-2950
Mailing address
2626 Watson Blvd
Eyeglass World
Warner Robins, GA 31093-2950
Phone (478) 273-6858
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40377 | Other | DAVIS VISION | |
| 000823985B | Medicaid | GA | |
| GA1734 | Other | ECPA AND EYE MED | |
| 12458 | Other | SPECTERA |
Other names
- Kevin X Xu
Other providers in Warner Robins, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.