Individual provider Active NPI

Rebekah Leigh Sanders, OD

  • Optometrist
  • Waco, TX
National Provider Identifier
1265057202
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9949 Issued in TX
Practice address
1000 W State Highway 6 Ste 210
Waco, TX 76712-3788
Phone
(254) 776-8119
NPI assigned
Jun 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 9949 TX Primary

Addresses

Primary practice location

1000 W State Highway 6 Ste 210
Waco, TX 76712-3788

Mailing address

1000 W State Highway 6 Ste 210
Waco, TX 76712-3788
Phone (254) 776-8119

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
I20200727002894 TX Practitioner - Optometry 3971928649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stacie Layne Virden OD PAGroup PAC ID 0749510253, 3 clinicians

Practice addresses (Care Compare)

1000 W State Hwy 6
Suite 210
Waco, TX 76712-3788
Phone (254) 776-8119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9949TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stacie Layne Virden OD PA Optometrist CurrentSince Jun 1, 2020 Accepting new patients

Locations

1000 W State Highway 6
Ste 210
Woodway, TX 76712
Phone (254) 776-8119

Organizations & group practices 1

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": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1265057202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W STATE HIGHWAY 6 STE 210",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123788",
            "telephone_number": "254-776-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W STATE HIGHWAY 6 STE 210",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123788",
            "telephone_number": "254-776-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "REBEKAH",
        "middle_name": "LEIGH",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.