Augustin C Pruneda Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2139 Issued in TX

Practice address

700 S Zarzamora St
Suite201
San Antonio, TX 78207-5255

Phone

(210) 436-8808

Fax

(210) 436-9163

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: augustin.pruneda@uprisedirect.com

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.

• Scott L Helgeson OD PLLC

  • Optometrist
  • McAllen, TX
  • NPI 1871020099
  Medicare reassignment NPD
• Augustin C Pruneda Jr

  • Optometrist
  • San Antonio, TX
  • NPI 1881878601
  NPD (past) Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1063430692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S ZARZAMORA ST",
            "address_2": "SUITE201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075255",
            "telephone_number": "210-436-8808",
            "fax_number": "210-436-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S ZARZAMORA ST",
            "address_2": "SUITE201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075255",
            "telephone_number": "210-436-8808",
            "fax_number": "210-436-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUNEDA",
        "first_name": "AUGUSTIN",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1335366-05",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Provider Care at Home LLC
• Providerx of San Antonio, LLC
• Alejandro Pruitt, MD
• Andrea Alicia Pruitt, R.N.
• Tabitha Vivens Pruitt
• Marilidia Aslan Pruneda
• Deepak Kumar Pruthi, MD
• Subha Pruthi, DMD
• Courtney Norris Pryor, LCSW
• Kacie McKenna Pryor

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.