Individual provider Active NPI

Samira Foshat Alejos, O.D.

  • Optometrist
  • Cedar Park, TX
National Provider Identifier
1194157487
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8209-T Issued in TX
Practice address
1455 E Whitestone Blvd Ste G145
Cedar Park, TX 78613-7722
Phone
(254) 615-1082
Fax
(254) 615-1097
NPI assigned
Aug 8, 2013
Last updated
Jun 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8209-T TX Primary

Addresses

Primary practice location

1455 E Whitestone Blvd Ste G145
Cedar Park, TX 78613-7722

Mailing address

15204 Killdeer St
Austin, TX 78734-6364
Phone (305) 763-9287

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
I20131203001347 TX Practitioner - Optometry 9537395140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Vision Group PLLCGroup PAC ID 4284016031, 2 clinicians

Practice addresses (Care Compare)

1455 E Whitestone Blvd
Suite G145
Cedar Park, TX 78613-7722
Phone (254) 615-1082

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8209-TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Vision Group, PLLC Optometrist CurrentSince Jun 13, 2022 Accepting new patients

Locations

1455 E Whitestone Blvd
Ste G145
Cedar Park, TX 78613
Phone (254) 615-1076

Organizations & group practices 1

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1194157487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15204 KILLDEER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787346364",
            "telephone_number": "305-763-9287",
            "fax_number": "254-615-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E WHITESTONE BLVD STE G145",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137722",
            "telephone_number": "254-615-1082",
            "fax_number": "254-615-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEJOS",
        "first_name": "SAMIRA",
        "middle_name": "FOSHAT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8209-T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.