Individual provider Active NPI

Derek NG, OD

  • Optometrist
  • Pasadena, TX
National Provider Identifier
1245072776
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11091 Issued in TX
Practice address
4450 E Sam Houston Pkwy S
Pasadena, TX 77505-3950
Phone
(713) 473-5715
NPI assigned
Jun 6, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11091 TX Primary

Addresses

Primary practice location

4450 E Sam Houston Pkwy S
Pasadena, TX 77505-3950

Mailing address

15806 72ND Ave
Fresh Meadows, NY 11365-4116
Phone (646) 639-2534

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
I20240823000333 TX Practitioner - Optometry 3173062098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pasadena Eye AssociatesGroup PAC ID 5496716953, 4 clinicians

Practice addresses (Care Compare)

4450 E Sam Houston Pkwy S
Suite E
Pasadena, TX 77505-3950
Phone (713) 473-5714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11091TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Eye Associates Optometrist CurrentSince Jul 29, 2024 Accepting new patients
Pasadena Eye Associates CurrentSince Jul 29, 2024 Accepting new patients

Locations

4450 E Sam Houston Pkwy S
Ste E
Pasadena, TX 77505
Phone (713) 473-5714

Interoperability endpoints

  • Direct secure messaging: nderek@pasadenaeye.updoxdirect.com
  • FHIR API: https://app.meldrx.com/api/fhir/XBTUN9D1

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": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1245072776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15806 72ND AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654116",
            "telephone_number": "646-639-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 E SAM HOUSTON PKWY S",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053950",
            "telephone_number": "713-473-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "DEREK",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.