Individual provider Active NPI

Kristen Watt, OD

  • Optometrist
  • Stephenville, TX
National Provider Identifier
1366002032
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9709T Issued in TX
Practice address
261 N Harbin Dr
Stephenville, TX 76401-2814
Phone
(254) 968-2345
NPI assigned
Jun 16, 2019
Last updated
Jul 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9709T TX Primary

Addresses

Primary practice location

261 N Harbin Dr
Stephenville, TX 76401-2814

Mailing address

227 Rosebud Dr
Stephenville, TX 76401-6078
Phone (928) 814-9806

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
I20190808001522 TX Practitioner - Optometry 4688901036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David Moore OD PCGroup PAC ID 0244387256, 2 clinicians

Practice addresses (Care Compare)

2545 Northwest Loop
Stephenville, TX 76401-1601
Phone (254) 968-2345

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9709TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
David Moore, O.D., P.C. Optometrist CurrentSince Aug 1, 2019 Accepting new patients

Locations

2545 NW Loop
Stephenville, TX 76401
Phone (254) 968-2345

261 N Harbin Dr
Stephenville, TX 76401
Phone (254) 968-2345

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, 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": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1366002032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 ROSEBUD DR",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764016078",
            "telephone_number": "928-814-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N HARBIN DR",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012814",
            "telephone_number": "254-968-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "KRISTEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-16",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9709T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

Verify at the official NPI Registry.