Kevin J Sjodahl, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10154 Issued in TX

Practice address

2116 Hancock Dr
Austin, TX 78756-2507

Phone

(512) 371-0144

Fax

(517) 371-0164

NPI assigned

Aug 12, 2008

Last updated

Sep 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment Care Compare group NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Austin, TX
  • NPI 1205429883
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Pearle Visioncare, Inc

  dba Pearle Vision #C6025

  • Eyewear Supplier
  • San Jose, CA
  • NPI 1174688188
  NPD (past)
• Silver Spring Optometry, LLC

  dba My Eye Dr

  • Optometrist
  • Silver Spring, MD
  • NPI 1336204387
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1396991287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 HANCOCK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787562507",
            "telephone_number": "512-371-0144",
            "fax_number": "517-371-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SJODAHL",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Sivan, LPC
• Edna Sivori, OTR/L
• Roslyn Janice Sixta, PTA
• Tiffany Jane Sizemore, LCSW
• SJC Austin Chiropractic and Therapy
• SJT Ventures TX PC
• Matthew Blake Skaggs, PTA
• Sharron Livingston Skaggs, RN C LCDC
• Lisa Beth Skalla, LCSW
• Shonna Skarda, M.A., CALT, LDT

• Optometrist in Austin, TX
• Providers in Austin, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.