Individual provider Active NPI

Brad R Aaron, O.D.

  • Optometrist
  • New Boston, TX
National Provider Identifier
1073588810
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4764-TG Issued in TX
Practice address
101 NE Front St
New Boston, TX 75570-2906
Phone
(903) 628-3937
Fax
(903) 832-4227
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4764-TG TX Primary

Addresses

Primary practice location

101 NE Front St
New Boston, TX 75570-2906

Mailing address

101 NE Front St
New Boston, TX 75570-2906
Phone (903) 628-3937

Other identifiers 2

IdentifierTypeStateIssuer
158214722MedicaidAR
019400301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050321000376 TX Practitioner - Optometry 2264487487 Practice locations: New Boston, TX
I20190813003431 AR Practitioner - Optometry 2264487487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 NE Front St
New Boston, TX 75570-2906
Phone (903) 628-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4764-TGTXMDOptometrist
3012OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Jun 23, 2019 Accepting new patients

Locations

114 E 49th St
Texarkana, AR 71854
Phone (870) 774-2020

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 2

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1073588810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NE FRONT ST",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755702906",
            "telephone_number": "903-628-3937",
            "fax_number": "903-832-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NE FRONT ST",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755702906",
            "telephone_number": "903-628-3937",
            "fax_number": "903-832-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AARON",
        "first_name": "BRAD",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4764-TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158214722",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019400301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Boston, TX

Sources for this page

Verify at the official NPI Registry.