Individual provider Active NPI

Amy Annette Jasinski, O.D.

  • Optometrist
  • Highland Village, TX
National Provider Identifier
1104113265
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7871TG Issued in TX
Practice address
2430 Justin Road
Suite a
Highland Village, TX 75077
Phone
(972) 317-3937
Fax
(972) 317-2320
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7871T TX
Optometrist 152W00000X 7871TG TX Primary

Addresses

Primary practice location

2430 Justin Road
Suite a
Highland Village, TX 75077

Mailing address

2430 Justin Road
Suite a
Highland Village, TX 75077

Other names 1

  • Dr. Amy Annette Clem Former name

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
I20120326000784 TX Practitioner - Optometry 6103086319 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ousley Vision PLLCGroup PAC ID 0840685517, 8 clinicians

Practice addresses (Care Compare)

2430 Justin Rd
Suite a
Highland Village, TX 75077-3090
Phone (972) 317-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7871TTXMDOptometrist
7871TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ousley Vision PLLC Optometrist CurrentSince Mar 1, 2022 Accepting new patients

Locations

2430 Justin Rd
Ste A
Lewisville, TX 75077
Phone (972) 317-3937

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1104113265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 JUSTIN ROAD",
            "address_2": "SUITE A",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "75077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 JUSTIN ROAD",
            "address_2": "SUITE A",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "75077",
            "telephone_number": "972-317-3937",
            "fax_number": "972-317-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASINSKI",
        "first_name": "AMY",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7871T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7871TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "CLEM",
            "middle_name": "ANNETTE",
            "prefix": "DR.",
            "credential": "O.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland Village, TX

Sources for this page

Verify at the official NPI Registry.