Individual provider Active NPI

Paul Michael Palumbo, O.D.

  • Optometrist
  • Kingwood, TX
National Provider Identifier
1184903361
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7715TG Issued in TX
Practice address
22741 Professional Dr
Kingwood, TX 77339-6005
Phone
(281) 319-4334
Fax
(281) 319-4855
NPI assigned
Aug 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7715TG TX Primary

Addresses

Primary practice location

22741 Professional Dr
Kingwood, TX 77339-6005

Mailing address

22741 Professional Dr
Kingwood, TX 77339-6005
Phone (281) 319-4334

Other practice location 1

3100 Weslayan St
Suite 400
Houston, TX 77027-5727
Phone (713) 526-1600

Other identifiers 3

IdentifierTypeStateIssuer
287247501MedicaidTX
287247502MedicaidTX
287247503MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paul.palumbo@direct.berkeleyeye.com Berkeley Eye Institute, PLLC

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
I20111229000571 TX Practitioner - Optometry 1951577618 Reassigns benefits to 1 organization

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
Berkeley Eye Institute, PLLCGroup PAC ID 4082602156, 62 clinicians

Practice addresses (Care Compare)

22741 Professional Dr
Kingwood, TX 77339-6005
Phone (281) 319-4334

Merit-based Incentive Payment System (MIPS)

Final score
89.82 of 100Reported as group
Quality
81.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7715TXMDBehavioral Analyst
7715TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley Eye Institute, PLLC Optometrist Current Accepting new patients
Berkeley Eye Institute, PLLC Optometrist CurrentSince Nov 1, 2011 Accepting new patients
Berkeley Eye Institute, PLLC Optometrist CurrentSince Nov 1, 2011 Accepting new patients
Clear Lake Eye Center LLP Optometrist Past Accepting new patients

Locations

605 Medical Ct
Ste 203
Brenham, TX 77833
Phone (979) 353-5556

3100 Weslayan St
Ste 400
Houston, TX 77027
Phone (713) 526-1600

22741 Professional Dr
Kingwood, TX 77339
Phone (281) 319-4334

1535 Cullen Blvd
Ste 200
Pearland, TX 77581
Phone (713) 436-1551

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1184903361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22741 PROFESSIONAL DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773396005",
            "telephone_number": "281-319-4334",
            "fax_number": "281-319-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22741 PROFESSIONAL DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773396005",
            "telephone_number": "281-319-4334",
            "fax_number": "281-319-4855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Weslayan St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770275727",
            "country_code": "US",
            "telephone_number": "713-526-1600",
            "fax_number": "713-620-7697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-05",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7715TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287247501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287247502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287247503",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paul.palumbo@direct.berkeleyeye.com",
            "affiliation": "Y",
            "affiliationName": "Berkeley Eye Institute, PLLC",
            "address_1": "22741 Professional Dr",
            "city": "Kingwood",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773396005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.