Individual provider Active NPI

David Gabriel Mora-Boellstorff, MD

  • Ophthalmology Physician
  • Bryan, TX
National Provider Identifier
1285196006
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
W7091 Issued in TX
Practice address
3387 University Dr E Ste 412
Bryan, TX 77802-3470
Phone
(713) 524-3434
Fax
(713) 524-3220
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X W7091 TX
Ophthalmology Physician 207W00000X W7091 TX Primary

Addresses

Primary practice location

3387 University Dr E Ste 412
Bryan, TX 77802-3470

Mailing address

PO Box 737507
Dallas, TX 75373-7507
Phone (713) 524-3434

Other practice location 1

4460 Bissonnet St Ste 200
Bellaire, TX 77401-3234
Phone (713) 524-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240411000341 OH Practitioner - Ophthalmology 0840610515 Reassigns benefits to 2 organizations
I20240411002275 KY Practitioner - Ophthalmology 0840610515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Medical School at Houston, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cei Physicians PSC, LLCGroup PAC ID 0749186427, shared by 6 NPIs, 155 clinicians
University of Cincinnati Physicians Company LLCGroup PAC ID 2264344480, 1,474 clinicians

Practice addresses (Care Compare)

1945 Cei Dr
Blue Ash, OH 45242-5664
Phone 51398451333741

3130 Highland Ave
Cincinnati, OH 45219-2399
Phone (513) 584-4503

580 S Loop Rd
Suite 200
Edgewood, KY 41017-3415
Phone 51398451333741

Hospital & facility affiliations

  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003
  • Cincinnati Children'S Hospital Medical Center Hospital, Cincinnati, OH, CCN 363300

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.150069OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cei Physicians PSC LLC Ophthalmology CurrentSince Apr 1, 2024 Accepting new patients
Cei Physicians PSC, LLC CurrentSince Apr 1, 2024 Accepting new patients
Cei Physicians PSC LLC Ophthalmology CurrentSince Apr 1, 2024 Accepting new patients
University of Cincinnati Physicians Company, LLC CurrentSince Jul 1, 2024 Accepting new patients
Retina Consultants of Houston PLLC Ophthalmology PastSince Jul 1, 2026 Accepting new patients
Cei Physicians PSC LLC Past Accepting new patients
Retina Consultants of Houston PLLC Ophthalmology Past Accepting new patients
Retina Consultants of Houston PLLC Ophthalmology Past Accepting new patients

Locations

580 S Loop Rd
Edgewood, KY 41017
Phone (859) 301-6000

580 S Loop Rd
Ste 200
Edgewood, KY 41017
Phone (859) 331-9000

9997 Carver Rd
Ste 200
Blue Ash, OH 45242

1945 Cei Dr
Blue Ash, OH 45242

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

200 Albert Sabin Way
Cincinnati, OH 45267
Phone (513) 475-7500

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3310 Mercy Health Blvd
Ste 220
Cincinnati, OH 45211
Phone (513) 654-2299

601 Ivy Gtwy
Ste 301
Cincinnati, OH 45245
Phone (513) 654-2299

3130 Highland Ave
Cincinnati, OH 45219
Phone (513) 584-4061

563 Wessel Dr
Fairfield, OH 45014
Phone (513) 858-6500

6150 Radio Way
Mason, OH 45040
Phone (513) 770-4020

5850 Innovation Dr
Middletown, OH 45005
Phone 5134259796 ext. 59796

Interoperability endpoints

  • Direct secure messaging: dmoraboellstorff1101506@wm.providencedirect.org
  • Direct secure messaging: david.moraboellstorf.d1.p1@direct.cei.nextgenshare.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1285196006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 737507",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753737507",
            "telephone_number": "713-524-3434",
            "fax_number": "713-524-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3387 UNIVERSITY DR E STE 412",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023470",
            "telephone_number": "713-524-3434",
            "fax_number": "713-524-3220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4460 Bissonnet St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774013234",
            "country_code": "US",
            "telephone_number": "713-524-3434",
            "fax_number": "713-524-3220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORA-BOELLSTORFF",
        "first_name": "DAVID",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "W7091",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "W7091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.