Individual provider Active NPI

Annela Arredondo, OD

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1346349933
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6550TG Issued in TX
Practice address
12730 W Ih 10
Suite 310a
San Antonio, TX 78230-1003
Phone
(210) 690-2002
Fax
(210) 690-2028
NPI assigned
Sep 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 6550TG TX Primary

Addresses

Primary practice location

12730 W Ih 10
Suite 310a
San Antonio, TX 78230-1003

Mailing address

12730 W Ih 10
Suite 310a
San Antonio, TX 78230-1003
Phone (210) 690-2002

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
I20050406001090 TX Practitioner - Optometry 6002863503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12730 W Interstate 10
Suite 310a
San Antonio, TX 78230-1004
Phone (210) 690-2002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6550TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Annela Arredondo & Associates, PA Optometrist CurrentSince Feb 7, 2005 Accepting new patients
All About Eyes, PA Optometrist PastSince Feb 7, 2005 Accepting new patients

Locations

12730 W Interstate 10
Ste 310A
San Antonio, TX 78230
Phone (210) 690-2002

Organizations & group practices 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346349933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 W IH 10",
            "address_2": "SUITE 310A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301003",
            "telephone_number": "210-690-2002",
            "fax_number": "210-690-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12730 W IH 10",
            "address_2": "SUITE 310A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301003",
            "telephone_number": "210-690-2002",
            "fax_number": "210-690-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "ANNELA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6550TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.