Individual provider Active NPI

Heather Victoria Broyles, DO

  • Ophthalmology Physician
  • Austin, TX
National Provider Identifier
1043714280
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
T5834 Issued in TX
Practice address
3944 RR 620 S Ste 222
Austin, TX 78738-7000
Phone
(512) 263-1113
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X T5834 TX Primary

Addresses

Primary practice location

3944 RR 620 S Ste 222
Austin, TX 78738-7000

Mailing address

3944 RR 620 S Ste 222
Austin, TX 78738-7000
Phone (512) 263-1113

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524001253 TX Practitioner - Ophthalmology 9830424332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Austin Eye PLLCGroup PAC ID 9436305406, 2 clinicians

Practice addresses (Care Compare)

3944 RR 620
BLDG 8 Suite 222
Austin, TX 78738-7000
Phone (512) 263-1113

Merit-based Incentive Payment System (MIPS)

Final score
97.26 of 100Reported as group
Quality
94.53
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 7, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Ophthalmology CurrentSince Jul 7, 2022 Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

5303 Harry Hines Blvd
Fl 6
Dallas, TX 75390
Phone (214) 645-2225

800 8th Ave
Ste 306
Fort Worth, TX 76104
Phone (817) 336-1300

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1043714280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3944 RR 620 S STE 222",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787387000",
            "telephone_number": "512-263-1113",
            "fax_number": "512-263-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3944 RR 620 S STE 222",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787387000",
            "telephone_number": "512-263-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "HEATHER",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "T5834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.