Joseph Bryan Ahlborn, O.D.
Individual provider Active NPI Optometrist · Fort Benning, GA
NPI 1124366687 · NPPES record last updated Aug 10, 2026
Key facts
- NPI
- 1124366687
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 8052 (TX)
- Practice address
- 6600 Van Aalst Blvd
Fort Benning, GA 31905-2102 - Phone
- (762) 408-0455
- NPI assigned
- Jan 17, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2080 N State Hwy 360
Suite 270
Grand Prairie, TX 75050-1458
Phone (817) 633-2020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230309000045 | TX | Practitioner - Optometry | 6204209463 | Reassigns benefits to 1 organization |
| I20240815001075 | HI | Practitioner - Optometry | 6204209463 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8052 | TX | MD | Rehabilitation Chiropractor |
Practice roles (5 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahl Eyecare PLLC | Optometrist | Current |
Accepting new patients |
| Lanai Community Health Center | Current |
Accepting new patients | |
| Phoebe Physician Group, Inc | Past | Accepting new patients | |
| West Hawaii Community Health Center, Inc. | Past | Accepting new patients | |
| Lanai Community Health Center | Past |
Accepting new patients |
Locations
2080 N State Highway 360
Ste 270
Grand Prairie, TX 75050
Phone (817) 633-2020
Networks
- HI PPO
- devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8052 | TX | Yes |
| Corneal and Contact Management Optometrist | 152WC0802X | 8052 | TX |
Addresses
Primary practice location
6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Mailing address
6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Phone (762) 408-2273
Other providers in Fort Benning, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.