Individual provider Active NPI

Jordan Emma Moczygemba, OD

  • Optometrist
  • Spring, TX
National Provider Identifier
1386482669
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11133T Issued in TX
Practice address
8220 Louetta Rd Ste 112
Spring, TX 77379-7021
Phone
(281) 370-2020
Fax
(281) 251-2705
NPI assigned
Jul 19, 2024
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11133T TX Primary

Addresses

Primary practice location

8220 Louetta Rd Ste 112
Spring, TX 77379-7021

Mailing address

9789 Katy Fwy Apt 1109
Houston, TX 77024-1372
Phone (210) 473-6785

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
I20250205001093 TX Practitioner - Optometry 2567992605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Klein Eyecare PAGroup PAC ID 3476599010, 4 clinicians

Practice addresses (Care Compare)

8220 Louetta Rd
Suite 112
Spring, TX 77379-7021
Phone (281) 370-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Klein Eyecare, P.a. Optometrist CurrentSince Dec 1, 2024 Accepting new patients

Locations

8220 Louetta Rd
Ste 112
Spring, TX 77379
Phone (281) 370-2020

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": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1386482669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9789 KATY FWY APT 1109",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241372",
            "telephone_number": "210-473-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 LOUETTA RD STE 112",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773797021",
            "telephone_number": "281-370-2020",
            "fax_number": "281-251-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCZYGEMBA",
        "first_name": "JORDAN",
        "middle_name": "EMMA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-19",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11133T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.