Individual provider Active NPI

Natalie Anysa Trevino, OD

  • Optometrist
  • Corpus Christi, TX
National Provider Identifier
1386493153
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11158 Issued in TX
Practice address
5488 S Padre Island Dr Ste 2042
Corpus Christi, TX 78411-4122
Phone
(361) 994-0310
Fax
(361) 257-1314
NPI assigned
May 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Optometrist 152W00000X 11158 TX Primary

Addresses

Primary practice location

5488 S Padre Island Dr Ste 2042
Corpus Christi, TX 78411-4122

Mailing address

5488 S Padre Island Dr Ste 2042
Corpus Christi, TX 78411-4122
Phone (361) 994-0310

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
I20240621000297 TX Practitioner - Optometry 8628511409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors McIntyre and GarzaGroup PAC ID 4183604861, 11 clinicians

Practice addresses (Care Compare)

5488 S Padre Island Dr
Suite 2042
Corpus Christi, TX 78411-4122
Phone (361) 994-0310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11158TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors McIntyre and Garza Optometrist CurrentSince Jun 18, 2024 Accepting new patients

Locations

5488 Spid Dr
Ste 2042
Corpus Christi, TX 78411
Phone (361) 994-0310

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": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1386493153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5488 S PADRE ISLAND DR STE 2042",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114122",
            "telephone_number": "361-994-0310",
            "fax_number": "361-257-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5488 S PADRE ISLAND DR STE 2042",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114122",
            "telephone_number": "361-994-0310",
            "fax_number": "361-257-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "NATALIE",
        "middle_name": "ANYSA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.