Individual provider Active NPI

Nicole Alexandra Karson, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1154995959
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10207 Issued in TX
Practice address
4401 Martin Luther King Blvd
Houston, TX 77204-2020
Phone
(713) 743-2020
Fax
(713) 743-0963
NPI assigned
May 17, 2021
Last updated
May 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 10207 TX Primary

Addresses

Primary practice location

4401 Martin Luther King Blvd
Houston, TX 77204-2020

Mailing address

4401 Martin Luther King Blvd
Houston, TX 77204-2020
Phone (713) 743-2020

Other identifiers 1

IdentifierTypeStateIssuer
425970701MedicaidTX

Other names 1

  • Nicole Alexandra Hedrick 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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723002616 TX Practitioner - OptometryPractitioner - Ophthalmology 2163825464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OptometryAlso: Ophthalmology
Education
University of Houston - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6651 Main St
Suite F1500
Houston, TX 77030-2355
Phone (713) 797-1144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Houston CurrentSince Jul 15, 2021 Accepting new patients
University of Houston System CurrentSince Jul 15, 2021 Accepting new patients
University of Houston System Optometrist Current Accepting new patients
Texas Children's Physician Group CurrentSince May 9, 2022 Accepting new patients

Locations

1102 Bates Ave
Ste 1440
Houston, TX 77030
Phone (832) 824-1065

190 Heights Blvd
Houston, TX 77007
Phone (713) 527-8480

4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921

4901 Calhoun Rd
Houston, TX 77204
Phone (713) 743-1921

6651 Main St
Ste F1500
Houston, TX 77030
Phone (504) 797-9677

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6701 Fannin St
Fl 5
Houston, TX 77030
Phone (832) 822-3200

Interoperability endpoints

  • Direct secure messaging: nkarson417679@prddirect.texaschildrens.org

Organizations & group practices 4

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1154995959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MARTIN LUTHER KING BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MARTIN LUTHER KING BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARSON",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425970701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HEDRICK",
            "middle_name": "ALEXANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.