Individual provider Active NPI

Andy Langston, OD, PA

  • Optometrist
  • Holiday Island, AR
National Provider Identifier
1336112465
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2430 Issued in AR
Practice address
1 Park Dr Ste B
Holiday Island, AR 72631-9221
Phone
(479) 253-4040
Fax
(479) 253-5636
NPI assigned
Feb 9, 2006
Last updated
May 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2430 AR Primary

Addresses

Primary practice location

1 Park Dr Ste B
Holiday Island, AR 72631-9221

Mailing address

1 Park Dr Ste B
Holiday Island, AR 72631-9221
Phone (479) 253-4040

Other identifiers 1

IdentifierTypeStateIssuer
126039722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20040616001175 AR Practitioner - Optometry 4486638467 Reassigns benefits to 1 organization
Practice locations: Holiday Island, AR

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Center PAGroup PAC ID 5395713382, 8 clinicians

Practice addresses (Care Compare)

594 E Millsap Rd
Fayetteville, AR 72703-4096
Phone 4794422020107

Merit-based Incentive Payment System (MIPS)

Final score
90.36 of 100Reported as group
Quality
93.44
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2430ARMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Center, PA Optometrist CurrentSince May 1, 2007 Accepting new patients
McDonald Eye Services, PA Optometrist PastSince Aug 27, 2016 Accepting new patients
McDonald Eye Services, PA Optometrist Past Accepting new patients

Locations

594 E Millsap Rd
Fayetteville, AR 72703
Phone (479) 442-2020

Interoperability endpoints

  • Direct secure messaging: alangston@eyecenternwa.emadirect.md

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1336112465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK DR STE B",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319221",
            "telephone_number": "479-253-4040",
            "fax_number": "479-253-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK DR STE B",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319221",
            "telephone_number": "479-253-4040",
            "fax_number": "479-253-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGSTON",
        "first_name": "ANDY",
        "credential": "OD, PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126039722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holiday Island, AR

Sources for this page

Verify at the official NPI Registry.