Active NPI
Bob Joe, O.D.
- Optometrist
- Austin, TX
National Provider Identifier
1245276443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2286TG
- Practice address
- 8105 Shoal Creek Blvd
Suite a
Austin, TX 78757-8040 - Phone
- (512) 454-4641
- Fax
- (512) 454-1065
- NPI assigned
- Jun 22, 2006
- Last updated
- Mar 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2286TG | TX | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 2286TG | TX | |
| Pediatric Optometrist | 152WP0200X | 2286TG | TX |
Addresses
Primary practice location
8105 Shoal Creek Blvd
Suite a
Austin, TX 78757-8040
Mailing address
8105 Shoal Creek Blvd
Suite a
Austin, TX 78757-8040
Phone (512) 454-4641
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81662Q | Other | TX | BCBS UPIN |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2286TG | TX | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Awod, PLLC | Optometrist | Current | Accepting new patients |
Locations
8105 Shoal Creek Blvd
#A
Austin, TX 78757
Phone (512) 454-4641
Interoperability endpoints
- direct@austinoptometrygrouplpaustintx.compulinkdirect.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Austin, TX
- NPI 1326167016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1245276443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8105 SHOAL CREEK BLVD",
"address_2": "SUITE A",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787578040",
"telephone_number": "512-454-4641",
"fax_number": "512-454-1065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8105 SHOAL CREEK BLVD",
"address_2": "SUITE A",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787578040",
"telephone_number": "512-454-4641",
"fax_number": "512-454-1065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOE",
"first_name": "BOB",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "2286TG",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "TX",
"license": "2286TG",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "TX",
"license": "2286TG",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS UPIN",
"identifier": "81662Q",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.