Individual provider Active NPI

Yutaka Maki, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1255629937
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8054TG Issued in TX
Practice address
9725 Datapoint Dr
San Antonio, TX 78229-2384
Phone
(210) 283-6800
NPI assigned
Jul 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8054TG TX Primary

Addresses

Primary practice location

9725 Datapoint Dr
San Antonio, TX 78229-2384

Mailing address

9725 Datapoint Dr
San Antonio, TX 78229-2384
Phone (210) 283-6800

Other practice location 1

33 W 42nd St
New York, NY 10036-8005
Phone (212) 938-4000 ext. 5836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130304000050 TX Practitioner - Optometry 2567634926 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
8054TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Incarnate Word Optometrist CurrentSince Nov 1, 2012 Accepting new patients
University of the Incarnate Word CurrentSince Nov 1, 2012 Accepting new patients

Locations

9725 Datapoint Dr
#69
San Antonio, TX 78229
Phone (210) 283-6800

2547 E Commerce St
San Antonio, TX 78203
Phone (210) 283-6331

9725 Datapoint Dr
San Antonio, TX 78229
Phone (210) 283-6800

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1255629937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 DATAPOINT DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292384",
            "telephone_number": "210-283-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 DATAPOINT DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292384",
            "telephone_number": "210-283-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 W 42nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100368005",
            "country_code": "US",
            "telephone_number": "212-938-4000 x5836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKI",
        "first_name": "YUTAKA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8054TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.