NPIMap

Organization Active NPI

Leander Eye Care PC

  • Optometrist
  • Leander, TX
National Provider Identifier
1417279480
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6974T Issued in TX
Legal business name
LEANDER EYE CARE PC
Practice address
1395 South U.S. Highway 183
Suite 130
Leander, TX 78641
Phone
(512) 259-8484
Fax
(713) 995-0548
NPI assigned
Feb 18, 2010
Last updated
Jun 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Authorized official

Name
Jason A Prescott, O.D.NPI 1831218171
Title
Owner/OD
Phone
(512) 259-8484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6974T TX Primary

Addresses

Primary practice location

1395 South U.S. Highway 183
Suite 130
Leander, TX 78641

Mailing address

1395 South U.S. Highway 183
Suite 130
Leander, TX 78641
Phone (512) 259-8484

Other identifiers 2

IdentifierTypeStateIssuer
212078401MedicaidTX
6974TOtherTXOPTOMETRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100525000132 TX Part B Supplier - Clinic/Group Practice 0042349391 Receives reassigned benefits from 5 practitioners
Practice locations: Leander, TX; Lampasas, TX; Alice, TX

National Provider Directory

National Provider Directory

Locations

107 Sheila Dr
Leander, TX 78641
Phone (512) 259-8484

1395 S Highway 183
Leander, TX 78641

1395 S Highway 183
Ste 130
Leander, TX 78641
Phone (512) 259-8484

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": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309219200000",
    "number": "1417279480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 SOUTH U.S. HIGHWAY 183",
            "address_2": "SUITE 130",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "78641",
            "telephone_number": "512-259-8484",
            "fax_number": "713-995-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 SOUTH U.S. HIGHWAY 183",
            "address_2": "SUITE 130",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "78641",
            "telephone_number": "512-259-8484",
            "fax_number": "713-995-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEANDER EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2011-06-28",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/OD",
        "authorized_official_telephone_number": "512-259-8484",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6974T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212078401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "6974T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leander, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.