Kristan L Gibson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

07027T Issued in TX

Practice address

3333 Bayshore Blvd
Suite 280
Pasadena, TX 77504-1952

Phone

(713) 943-8671

Fax

(713) 943-1657

NPI assigned

Oct 25, 2006

Last updated

Oct 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Optometry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Eye Associates PLLCGroup PAC ID 2264479112, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coastal Eye Associates PLLC

  • Ophthalmology Physician
  • Webster, TX
  • NPI 1922070036

  Optometrist

  Medicare reassignment Care Compare group NPD
• Coastal Eye Associates, PLLC

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1407045958

  Optometrist

  NPD
• Coastal Eye Associates, PLLC

  • Ophthalmology Physician
  • Alvin, TX
  • NPI 1407980725

  Optometrist

  NPD
• Coastal Eye Associates, PLLC

  • Ophthalmology Physician
  • Texas City, TX
  • NPI 1467586776

  Optometrist

  NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1093899890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E MEDICAL CENTER BLVD",
            "address_2": "SUITE 101",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984367",
            "telephone_number": "281-488-7213",
            "fax_number": "281-488-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BAYSHORE BLVD",
            "address_2": "SUITE 280",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041952",
            "telephone_number": "713-943-8671",
            "fax_number": "713-943-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KRISTAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "07027T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4130",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "193100005",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213909901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213909902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jojy Mattackal George, M.D.
• Germ Management LLC (RVS Pharmacy)
• Ashkan John Ghorbani, MD
• Gian S Bedi MD PA
• Jerry Dean Gibson, MD
• Gilbert Family Practice PLLC (CornerstoneMD)
• Louis Gilbert, D.O.
• Timberly Gilford, M.D.
• Kevin Clyde Gill, D.D.S.
• Daniel Giv, D.D.S.

• Optometrist in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.