Individual provider Active NPI

Dennis Roland McCarty, OD

  • Optometrist
  • Cedar Park, TX
National Provider Identifier
1083785950
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5874TG Issued in TX
Practice address
210 N Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2081
Phone
(512) 249-0808
Fax
(512) 249-0828
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5874TG TX Primary

Addresses

Primary practice location

210 N Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2081

Mailing address

210 N Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2081
Phone (512) 249-0808

Other identifiers 1

IdentifierTypeStateIssuer
8B6525OtherTXMEDICARE ID

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
I20040616000624 TX Practitioner - Optometry 7012991128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 N Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2088
Phone (512) 249-0808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5874TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Park Eye Care PA Optometrist CurrentSince Jan 1, 2008 Accepting new patients

Locations

210 N Lakeline Blvd
Ste 100
Cedar Park, TX 78613
Phone (512) 249-0808

302 S Bell Blvd
Cedar Park, TX 78613
Phone (512) 249-0808

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1083785950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N LAKELINE BLVD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132081",
            "telephone_number": "512-249-0808",
            "fax_number": "512-249-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N LAKELINE BLVD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132081",
            "telephone_number": "512-249-0808",
            "fax_number": "512-249-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "DENNIS",
        "middle_name": "ROLAND",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5874TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "8B6525",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.