Individual provider Active NPI

Carey A Patrick, OD

  • Optometrist
  • Allen, TX
National Provider Identifier
1104824242
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
06243TG Issued in TX
Practice address
1546 Stacy Rd
Suite 100
Allen, TX 75002-8726
Phone
(214) 383-5400
Fax
(214) 383-5203
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 6243TG TX
Pediatric Optometrist 152WP0200X 6243TG TX
Sports Vision Optometrist 152WS0006X 6243TG TX
Optometrist 152W00000X 06243TG TX Primary

Addresses

Primary practice location

1546 Stacy Rd
Suite 100
Allen, TX 75002-8726

Mailing address

1546 Stacy Rd
Suite 100
Allen, TX 75002-8726
Phone (214) 383-5400

Other identifiers 2

IdentifierTypeStateIssuer
11411072OtherCAQH
162828101MedicaidTX

Other names 1

  • Carey S Aston 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
I20040207000148 TX Practitioner - Optometry 3870486285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1546 Stacy Rd
Suite 100
Allen, TX 75002-8721
Phone (214) 383-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06243TGTXMDOptometrist
6243TGTXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Eyecare, P.a. Optometrist CurrentSince Oct 1, 2007 Accepting new patients
Eyecare Professionals, PA Optometrist PastSince Jul 1, 2003 Accepting new patients

Locations

1546 Stacy Rd
Ste 100
Allen, TX 75002
Phone (214) 226-1538

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1104824242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 STACY RD",
            "address_2": "SUITE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750028726",
            "telephone_number": "214-383-5400",
            "fax_number": "214-383-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 STACY RD",
            "address_2": "SUITE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750028726",
            "telephone_number": "214-383-5400",
            "fax_number": "214-383-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "CAREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "6243TG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "6243TG",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "TX",
            "license": "6243TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06243TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11411072",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162828101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAREY",
            "last_name": "ASTON",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.