Individual provider Active NPI

Andre T Le, O.D.

  • Optometrist
  • Burleson, TX
National Provider Identifier
1073566022
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6555TG Issued in TX
Practice address
116 E Ellison St Ste C
Burleson, TX 76028-4286
Phone
(817) 295-9696
Fax
(817) 295-9313
NPI assigned
May 19, 2006
Last updated
Sep 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6555TG TX Primary

Addresses

Primary practice location

116 E Ellison St Ste C
Burleson, TX 76028-4286

Mailing address

116 E Ellison St Ste C
Burleson, TX 76028-4286
Phone (214) 998-0934

Other identifiers 3

IdentifierTypeStateIssuer
8F0158OtherTXMEDICARE PROVIDER NUMBER
177117201MedicaidTX
TX6555TGOtherTXOD LICENSE

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
I20050621000894 TX Practitioner - Optometry 9032154083 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Plaza PAGroup PAC ID 4789629734, 2 clinicians
Vision Care Associates of Burleson PLLCGroup PAC ID 9436668399, 2 clinicians

Practice addresses (Care Compare)

116 E Ellison St
Suite C
Burleson, TX 76028-4286
Phone (817) 295-9696

951 SW Wilshire Blvd
Burleson, TX 76028-5714
Phone (817) 883-1880

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6555TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care Associates of Burleson PLLC Optometrist CurrentSince Apr 7, 2025 Accepting new patients
Onsight Eyecare PLLC Optometrist CurrentSince Feb 24, 2026 Accepting new patients
Vision Plaza PA Optometrist CurrentSince Mar 8, 2005 Accepting new patients

Locations

116 E Ellison St
Ste C
Burleson, TX 76028
Phone (214) 998-0934

116 E Ellison St
Ste C3
Burleson, TX 76028

312 E Renfro St
Ste 107
Burleson, TX 76028
Phone (817) 239-2284

951 SW Wilshire Blvd
Burleson, TX 76028
Phone (214) 998-0934

Interoperability endpoints

  • Direct secure messaging: andre.le@uprisedirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1073566022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E ELLISON ST STE C",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284286",
            "telephone_number": "214-998-0934",
            "fax_number": "817-295-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E ELLISON ST STE C",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284286",
            "telephone_number": "817-295-9696",
            "fax_number": "817-295-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "ANDRE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6555TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "8F0158",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177117201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD LICENSE",
            "identifier": "TX6555TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.