Individual provider Active NPI

Elisa M Hearn, OD

  • Optometrist
  • Austin, TX
National Provider Identifier
1124139522
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6045T Issued in TX
Practice address
2900 W Anderson LN
Ste G
Austin, TX 78757-1102
Phone
(512) 451-6586
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6045T TX Primary

Addresses

Primary practice location

2900 W Anderson LN
Ste G
Austin, TX 78757-1102

Mailing address

PO Box 200101
Austin, TX 78720-0101

Other identifiers 1

IdentifierTypeStateIssuer
204154301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6045TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Laura Stancik, Optometrist, P. C. Optometrist PastSince Oct 24, 1998 Accepting new patients
Aeg Texas Professional PLLC Optometrist PastSince Dec 21, 2025 Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1124139522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787200101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W ANDERSON LN",
            "address_2": "STE G",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787571102",
            "telephone_number": "512-451-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARN",
        "first_name": "ELISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6045T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204154301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.