Individual provider Active NPI

Shawn Muldoon, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1356344618
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5004TG Issued in TX
Practice address
5874 Westheimer Rd
Houston, TX 77057-5641
Phone
(713) 974-2020
Fax
(713) 975-9756
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5004TG TX Primary

Addresses

Primary practice location

5874 Westheimer Rd
Houston, TX 77057-5641

Mailing address

5874 Westheimer Rd
Houston, TX 77057-5641
Phone (713) 974-2020

Other identifiers 2

IdentifierTypeStateIssuer
041116701MedicaidTX
041116702MedicaidTX

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
I20050914001378 TX Practitioner - Optometry 2860425329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5874 Westheimer Rd
Houston, TX 77057-5641
Phone (713) 974-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5004TGTXMDOptometrist

Organizations & group practices 1

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1356344618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5874 WESTHEIMER RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770575641",
            "telephone_number": "713-974-2020",
            "fax_number": "713-975-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5874 WESTHEIMER RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770575641",
            "telephone_number": "713-974-2020",
            "fax_number": "713-975-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDOON",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5004TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041116701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041116702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.