Individual provider Active NPI

Kwame Antwi-Boasiako, OD, PHD

  • Optometrist
  • Corpus Christi, TX
National Provider Identifier
1295401750
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10380T Issued in TX
Practice address
4701 S Padre Island Dr Ste a
Corpus Christi, TX 78411-4400
Phone
(361) 730-2375
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10380T TX Primary

Addresses

Primary practice location

4701 S Padre Island Dr Ste a
Corpus Christi, TX 78411-4400

Mailing address

5622 Leicester
Corpus Christi, TX 78414-6073
Phone (281) 624-9734

Other practice location 1

4701 S Padre Island Dr Ste A
Corpus Christi, TX 78411-4400
Phone (361) 730-2375

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
I20240209003817 TX Practitioner - Optometry 1355784901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

3903 Wiseman Blvd
San Antonio, TX 78251-4402
Phone (210) 946-1400

6002 S Staples St
Corpus Christi, TX 78413-2902
Phone (361) 334-2625

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10380TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2024 Accepting new patients
Christopher Majka MD PLLC CurrentSince Jan 22, 2024 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

5721 Esplanade Dr
Corpus Christi, TX 78414
Phone (361) 334-1300

6002 S Staples St
Corpus Christi, TX 78413
Phone (361) 334-2625

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

Interoperability endpoints

  • Direct secure messaging: kantwiboasiako@cppclinical.intellechartdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1295401750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5622 LEICESTER",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784146073",
            "telephone_number": "281-624-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 S PADRE ISLAND DR STE A",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114400",
            "telephone_number": "361-730-2375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 S Padre Island Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784114400",
            "country_code": "US",
            "telephone_number": "361-730-2375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTWI-BOASIAKO",
        "first_name": "KWAME",
        "credential": "OD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10380T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.