Individual provider Active NPI

Scott Robert Conroy, O.D.

  • Optometrist
  • Beaumont, TX
National Provider Identifier
1366555229
Registry record updated Apr 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4244T Issued in TX
Practice address
5854B Eastex Fwy
Beaumont, TX 77708-4824
Phone
(409) 899-1177
Fax
(409) 899-4115
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4244T TX Primary

Addresses

Primary practice location

5854B Eastex Fwy
Beaumont, TX 77708-4824

Mailing address

5854B Eastex Fwy
Beaumont, TX 77708-4824
Phone (409) 899-1177

Other identifiers 7

IdentifierTypeStateIssuer
20563OtherTXSPECTERA
760564863OtherTXNVA
019201501MedicaidTX
55927OtherTXSAFEGUARD
VTX000755OtherTXAVESIS
24FDOtherTXBLUE CROSS
613548OtherTXMEDICARE PTAN/PROVIDER #

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
I20090108000110 TX Practitioner - Optometry 2466514799 Practice locations: Beaumont, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5854 Eastex Fwy
Suite B
Beaumont, TX 77708-4824
Phone (409) 899-1177

5854B Eastex Fwy
Beaumont, TX 77708-4824

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4244TTXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777075200000",
    "number": "1366555229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5854B EASTEX FWY",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084824",
            "telephone_number": "409-899-1177",
            "fax_number": "409-899-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5854B EASTEX FWY",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084824",
            "telephone_number": "409-899-1177",
            "fax_number": "409-899-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2026-04-25",
        "certification_date": "2026-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4244T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "20563",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "760564863",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019201501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD",
            "identifier": "55927",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "VTX000755",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "24FD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN/PROVIDER #",
            "identifier": "613548",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.