NPIMap

Organization Active NPI

Coastal Eye Associates, PLLC

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1407045958
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
COASTAL EYE ASSOCIATES, PLLC
Practice address
11550 Fuqua St
Suite 250
Houston, TX 77034-4599
Phone
(281) 488-7213
Fax
(281) 669-3602
NPI assigned
Oct 22, 2007
Last updated
Feb 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Authorized official

Name
Mr. Kelly Ferree
Title
Executive Administrator
Phone
(281) 488-7213

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

11550 Fuqua St
Suite 250
Houston, TX 77034-4599

Mailing address

555 E Medical Center Blvd Ste 101
Webster, TX 77598-4367
Phone (281) 488-7213

Other identifiers 2

IdentifierTypeStateIssuer
345484501MedicaidTX
45D2057002OtherTXCLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050412000737 TX Part B Supplier - Clinic/Group Practice 2264479112 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Webster, TX; Houston, TX; Texas City, TX; Alvin, TX; Pasadena, TX
O20110311000350 TX DME Supplier - Physician - Optometrist 2264479112 Practice locations: Houston, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2057002Coastal Eye Associates PLLC11550 Fuqua #250, Houston, TX 77034Certificate of waiverApr 7, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Coastal Eye Associates11550 Fuqua St, Houston, TX 77034-4200(281) 488-7213 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Oct 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Coastal Eye Associates PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

400 Medic Ln
Ste D
Alvin, TX 77511
Phone (281) 331-0292

11550 Fuqua St
Ste 205
Houston, TX 77034
Phone (281) 669-3600

926 14th St N
#A
Texas City, TX 77590
Phone (409) 945-2269

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1407045958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E MEDICAL CENTER BLVD STE 101",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984367",
            "telephone_number": "281-488-7213",
            "fax_number": "281-488-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 FUQUA ST",
            "address_2": "SUITE 250",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770344599",
            "telephone_number": "281-488-7213",
            "fax_number": "281-669-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "FERREE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "281-488-7213",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345484501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2057002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.