Ryan Self, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

7724T Issued in TX

Practice address

3208 N University Dr
Nacogdoches, TX 75965-2633

Phone

(936) 564-7661

Fax

(936) 564-6622

NPI assigned

Jul 15, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nacogdoches Eye Associates, PLLCGroup PAC ID 2567647613, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nacogdoches Eye Associates, PLLC

  • Optometrist
  • Nacogdoches, TX
  • NPI 1356645964
  Medicare reassignment Care Compare group NPD
• Mark Lanier OD PC

  • Optometrist
  • Nacogdoches, TX
  • NPI 1235262163
  NPD (past)

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1356639009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632600",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759632600",
            "telephone_number": "936-564-7661",
            "fax_number": "936-564-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652633",
            "telephone_number": "936-564-7661",
            "fax_number": "936-564-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "RYAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7724T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Gay Schmidt, RN, FNP-C
• Katie K Schneider, CCC/SLP
• Jeffrey Brandt Schulz, LPC, LCDC
• Sharon Love Scifres, LCSW, ACSW
• Scott a Sims PA
• Marie Anderson Sell, BS, MT, MI, CLT
• Diana S Selvey, CNM
• Jared Session, MAT, LAT, ATC
• Sfa Mobility LLC
• Shadman Shaikh

• Optometrist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.