Individual provider Active NPI

Amanda Raye Martini, O.D.

  • Optometrist
  • Aransas Pass, TX
National Provider Identifier
1053448746
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6902T Issued in TX
Practice address
2501 W. Wheeler Ave.
Aransas Pass, TX 78336
Phone
(361) 758-3433
Fax
(361) 758-3424
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6902T TX Primary

Addresses

Primary practice location

2501 W. Wheeler Ave.
Aransas Pass, TX 78336

Mailing address

2501 W. Wheeler Ave.
Aransas Pass, TX 78336
Phone (361) 758-3433

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
I20110914000776 TX Practitioner - Optometry 1052582434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2501 W Wheeler Ave
Aransas Pass, TX 78336-5916
Phone (361) 758-3433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6902TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Vision Care, PC Optometrist CurrentSince Jun 12, 2013 Accepting new patients

Locations

2501 W Wheeler Ave
Aransas Pass, TX 78336
Phone (361) 758-2867

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1053448746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W. WHEELER AVE.",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "78336",
            "telephone_number": "361-758-3433",
            "fax_number": "361-758-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W. WHEELER AVE.",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "78336",
            "telephone_number": "361-758-3433",
            "fax_number": "361-758-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "AMANDA",
        "middle_name": "RAYE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6902T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aransas Pass, TX

Sources for this page

Verify at the official NPI Registry.