Susan Ly Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8940-TG Issued in TX

Practice address

124 E Bandera Rd Ste 403
Boerne, TX 78006-2849

Phone

(830) 331-8745

Fax

(830) 331-8749

NPI assigned

Aug 12, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boerne Vision Center PAGroup PAC ID 6305094285, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Boerne Vision Center PA

  • Optometrist
  • Boerne, TX
  • NPI 1609149731
  Medicare reassignment Care Compare group NPD Authorized official
• University of the Incarnate Word

  • Optometrist
  • San Antonio, TX
  • NPI 1003129784
  Medicare reassignment NPD
• University of the Incarnate Word

  • Family Nurse Practitioner
  • San Antonio, TX
  • NPI 1033591706
  NPD

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1235683889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E BANDERA RD STE 403",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062849",
            "telephone_number": "830-331-8745",
            "fax_number": "830-331-8749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E BANDERA RD STE 403",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062849",
            "telephone_number": "830-331-8745",
            "fax_number": "830-331-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSAN",
        "middle_name": "LY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8940-TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376410201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnson Eye Care PLLC
• Jennifer E Johnson, MS, CCC-SLP
• Jennifer L Johnson, O.D.
• Kenneth Jay Johnson
• Madeline Alexis Johnson
• Emma Ryckman Jonas
• Ashlie Solansky Jones, RN
• Brittany L Jones, D.D.S.
• Maureen Ann Jones, LPC
• Renee Jones, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.