Individual provider Active NPI

Punitkumar Bhakta, OD

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1205399383
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-E94-TA-C47 Issued in AL
Practice address
3800 S Zarzamora St
San Antonio, TX 78225-2118
Phone
(210) 386-4455
NPI assigned
Apr 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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 S-E94-TA-C47 AL Primary

Addresses

Primary practice location

3800 S Zarzamora St
San Antonio, TX 78225-2118

Mailing address

2850 Venice Rd Apt 5308
Birmingham, AL 35211-7020
Phone (210) 386-4455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220527001672 AL Practitioner - Optometry 0143608489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360Care Services of Al LLCGroup PAC ID 7719240977, 29 clinicians

Practice addresses (Care Compare)

150 S Perry St
Montgomery, AL 36104-4227
Phone (248) 528-2116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-E94-TA-C47ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
360Care Services of Al LLC Optometrist CurrentSince Feb 3, 2025 Accepting new patients
Aria Eye Care, LLC Optometrist CurrentSince May 18, 2022 Accepting new patients

Locations

211 Ana Dr
Florence, AL 35630
Phone (256) 760-9942

2740 Zelda Rd
Ste 5B
Montgomery, AL 36106
Phone (682) 234-1164

150 S Perry St
Montgomery, AL 36104
Phone (225) 270-1012

523 Gandy St NE
Ste A
Russellville, AL 35653
Phone (205) 208-9955

11 Bell Rd
Selma, AL 36701
Phone (334) 874-7425

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

Organizations & group practices 2

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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1205399383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 VENICE RD APT 5308",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352117020",
            "telephone_number": "210-386-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S ZARZAMORA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782252118",
            "telephone_number": "210-386-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "PUNITKUMAR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-07",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "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": "AL",
            "license": "S-E94-TA-C47",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.