Kimberly Lynne Menzie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8620T Issued in TX

Practice address

4945 Williams Dr
Georgetown, TX 78633-2008

Phone

(512) 819-0500

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Scott & White Clinic

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704
  Medicare reassignment Care Compare group NPD
• Kelsey-Seybold Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255
  Medicare reassignment NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796
  NPD
• Scott and White Clinic

  • Radiation Oncology Physician
  • Waxahachie, TX
  • NPI 1821475153
  NPD
• Scott & White Hospital - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scott & White Hospital - Round Rock

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1265568638
  Care Compare affiliation

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1194884411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4945 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332008",
            "telephone_number": "512-819-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENZIE",
        "first_name": "KIMBERLY",
        "middle_name": "LYNNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8620T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351131301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351131302",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmenzie788367@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4945 Williams Dr",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786332008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Mellencamp
• Ellen Clarice Melton, PHD, LPC
• Travis Mendenhall
• Devina Monique Mendez, PTA
• Crystal Maddox Mendl, RN
• Amanda Lorin Mercado, RBT
• Jill R Meredith, APRN,PNP-PC
• Celicia K Merritt
• Merton Medical
• Metx LLC

• Optometrist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.