Individual provider Active NPI

Victoria Defeo, O.D.

  • Optometrist
  • Austin, TX
National Provider Identifier
1295743979
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6067T Issued in TX
Practice address
14900 Avery Ranch Blvd
B500
Austin, TX 78717-3951
Phone
(512) 255-7987
Fax
(512) 255-4351
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6067T TX Primary

Addresses

Primary practice location

14900 Avery Ranch Blvd
B500
Austin, TX 78717-3951

Mailing address

14900 Avery Ranch Blvd
B500
Austin, TX 78717-3951
Phone (512) 255-7987

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
I20050425000650 TX Practitioner - Optometry 8123066693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultimate Eye CareGroup PAC ID 6406894971, 2 clinicians

Practice addresses (Care Compare)

14900 Avery Ranch Blvd
Suite B500
Austin, TX 78717-3957
Phone (512) 255-7987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6067TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Associates of Texas P.a. Optometrist PastSince Oct 16, 2022 Accepting new patients
Dr Brinegar and Associates Optometrist PastSince Apr 28, 2005 Accepting new patients

Organizations & group practices 3

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295743979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14900 AVERY RANCH BLVD",
            "address_2": "B500",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787173951",
            "telephone_number": "512-255-7987",
            "fax_number": "512-255-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 AVERY RANCH BLVD",
            "address_2": "B500",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787173951",
            "telephone_number": "512-255-7987",
            "fax_number": "512-255-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFEO",
        "first_name": "VICTORIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6067T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.