Individual provider Active NPI

Misty Brooke Leblanc, O.D.

  • Corneal and Contact Management Optometrist
  • Pampa, TX
National Provider Identifier
1093835464
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
6512TG Issued in TX
Practice address
1916 N Hobart St
Pampa, TX 79065-3413
Phone
(806) 669-2824
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 6512TG TX Primary

Addresses

Primary practice location

1916 N Hobart St
Pampa, TX 79065-3413

Mailing address

1916 N Hobart St
Pampa, TX 79065-3413
Phone (806) 669-2824

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
I20040611000794 TX Practitioner - Optometry 4688657489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Leblanc, PLLCGroup PAC ID 8022267731, 2 clinicians

Practice addresses (Care Compare)

2428 Perryton Pkwy
Pampa, TX 79065-2755
Phone (806) 669-2824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6512TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Leblanc, PLLC CurrentSince Oct 1, 2012 Accepting new patients
Bowen Eye Associates Past Accepting new patients
Ginter Eyecare Center Inc. Corneal and Contact Management PastSince Apr 12, 2019 Accepting new patients
Panhandle Eye Group, LLP PastSince Jan 19, 2004 Accepting new patients

Locations

1916 N Hobart St
Pampa, TX 79065
Phone (806) 669-2824

2428 Perryton Pkwy
Pampa, TX 79065
Phone (806) 669-2824

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1093835464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 N HOBART ST",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790653413",
            "telephone_number": "806-669-2824",
            "fax_number": "806-669-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 N HOBART ST",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790653413",
            "telephone_number": "806-669-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "MISTY",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "6512TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pampa, TX

Sources for this page

Verify at the official NPI Registry.