Individual provider Active NPI

Mary Kathryn Kelinske, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1356655468
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7601T Issued in TX
Practice address
1312 Bomar St
Houston, TX 77006-1122
Phone
(832) 594-8964
NPI assigned
Jul 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7601T TX Primary

Addresses

Primary practice location

1312 Bomar St
Houston, TX 77006-1122

Mailing address

1312 Bomar St
Houston, TX 77006-1122
Phone (832) 594-8964

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
I20100902000993 TX Practitioner - Optometry 9830213495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

15400 Southwest Fwy
Suite 200
Sugar Land, TX 77478-3877
Phone (281) 494-7010

6701 Fannin St
Houston, TX 77030-2608
Phone (832) 824-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7601TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Jan 10, 2013 Accepting new patients

Locations

6701 Fannin St
Ste 1060
Houston, TX 77030

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

Interoperability endpoints

  • Direct secure messaging: mkelinske141306@prddirect.texaschildrens.org

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": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1356655468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 BOMAR ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770061122",
            "telephone_number": "832-594-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 BOMAR ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770061122",
            "telephone_number": "832-594-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELINSKE",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-30",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7601T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.