Individual provider Active NPI

Roy Thomas York, O.D.

  • Optometrist
  • Wichita Falls, TX
National Provider Identifier
1205927704
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4904T Issued in TX
Practice address
4210 Kell Blvd
Suite 108
Wichita Falls, TX 76309-4802
Phone
(940) 692-9696
Fax
(940) 692-7303
NPI assigned
Sep 27, 2006
Last updated
Aug 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4904T TX Primary
Optometrist 152W00000X 2088 OK

Addresses

Primary practice location

4210 Kell Blvd
Suite 108
Wichita Falls, TX 76309-4802

Mailing address

4210 Kell Blvd
Suite 108
Wichita Falls, TX 76309-4802
Phone (940) 692-9696

Other identifiers 1

IdentifierTypeStateIssuer
038652601MedicaidTX

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
I20110208000540 TX Practitioner - Optometry 1658551619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Laura Stancik, Optometrist, P. C.Group PAC ID 3971598418, 3 clinicians

Practice addresses (Care Compare)

4210 Kell Blvd
Suite 108
Wichita Falls, TX 76309-4813
Phone (940) 692-9696

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2088OKMDMental Health Counselor
4904TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Laura Stancik, Optometrist, P. C. Optometrist CurrentSince Jul 19, 2000 Accepting new patients

Locations

4210 Kell Blvd
Ste 108
Wichita Falls, TX 76309
Phone (940) 692-9696

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1205927704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 KELL BLVD",
            "address_2": "SUITE 108",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094802",
            "telephone_number": "940-692-9696",
            "fax_number": "940-692-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 KELL BLVD",
            "address_2": "SUITE 108",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094802",
            "telephone_number": "940-692-9696",
            "fax_number": "940-692-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "ROY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4904T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2088",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038652601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.