Individual provider Active NPI

Macon Dale Newcomer, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1073174405
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9702TG Issued in TX
Practice address
8800 Katy Fwy Ste 107
Houston, TX 77024-1645
Phone
(713) 827-8311
Fax
(713) 827-7488
NPI assigned
Jun 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9702 TX
Optometrist 152W00000X 9702TG TX Primary

Addresses

Primary practice location

8800 Katy Fwy Ste 107
Houston, TX 77024-1645

Mailing address

8800 Katy Fwy Ste 107
Houston, TX 77024-1645
Phone (713) 827-8311

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnewcomer@direct.berkeleyeye.com Berkeley Eye Institute, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210621002909 FL Practitioner - Optometry 3678809381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newcomer Eyecare II, P.a.Group PAC ID 7214052836, 3 clinicians
Newcomer Eye Care I P aGroup PAC ID 8628148384, 3 clinicians

Practice addresses (Care Compare)

3636 N Lecanto Hwy
Beverly Hills, FL 34465-3513
Phone (352) 746-0800

4564 S Suncoast Blvd
Homosassa, FL 34446-1103
Phone (352) 628-3029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9702TXMDOptometrist
9702TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Newcomer Eye Care I P a Optometrist CurrentSince Jun 28, 2021 Accepting new patients
Newcomer Eyecare II, P.a. Optometrist CurrentSince Jun 28, 2021 Accepting new patients
Clear Lake Eye Center LLP Optometrist Past Accepting new patients

Locations

3636 N Lecanto Hwy
Beverly Hills, FL 34465
Phone (352) 746-0800

4564 S Suncoast Blvd
Homosassa, FL 34446
Phone (352) 628-3029

Organizations & group practices 3

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1073174405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 KATY FWY STE 107",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241645",
            "telephone_number": "713-827-8311",
            "fax_number": "713-827-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 KATY FWY STE 107",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241645",
            "telephone_number": "713-827-8311",
            "fax_number": "713-827-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMER",
        "first_name": "MACON",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9702",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9702TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnewcomer@direct.berkeleyeye.com",
            "affiliation": "Y",
            "affiliationName": "Berkeley Eye Institute, PLLC",
            "address_1": "8800 Katy Fwy Ste 107",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770241645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.