Individual provider Active NPI

Karl L Wedel, O.D.

  • Optometrist
  • Cleburne, TX
National Provider Identifier
1235137811
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1964 Issued in TX
Practice address
839 N Nolan River Rd
Cleburne, TX 76033-7001
Phone
(817) 645-2411
Fax
(817) 645-3447
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1964TG TX
Optometrist 152W00000X 1964 TX Primary

Addresses

Primary practice location

839 N Nolan River Rd
Cleburne, TX 76033-7001

Mailing address

839 N Nolan River Rd
Cleburne, TX 76033-7001
Phone (817) 645-2411

Other identifiers 3

IdentifierTypeStateIssuer
80182QOtherTXBLUE CROSS BLUE SHIELD
1272320-02MedicaidTX
20729OtherTXOPTICARE

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
I20100727000168 TX Practitioner - Optometry 7719010842 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1964TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin, Wedel & Bullard, P.C. Optometrist CurrentSince Nov 1, 1998 Accepting new patients
Martin, Wedel & Bullard, P.C. Optometrist CurrentSince Nov 1, 1998 Accepting new patients
Martin, Wedel & Bullard, P.C. Optometrist Past Accepting new patients

Locations

110 W Henderson St
Cleburne, TX 76033
Phone (817) 645-2411

839 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 645-2411

4460 E Highway 287
Ste A
Midlothian, TX 76065
Phone (972) 775-8000

Organizations & group practices 3

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1235137811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 N NOLAN RIVER RD",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337001",
            "telephone_number": "817-645-2411",
            "fax_number": "817-645-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 N NOLAN RIVER RD",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337001",
            "telephone_number": "817-645-2411",
            "fax_number": "817-645-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDEL",
        "first_name": "KARL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1964TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80182Q",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1272320-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE",
            "identifier": "20729",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.