Individual provider Active NPI

Anna McKinney, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1417339581
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8659T Issued in TX
Practice address
16793 San Pedro Ave
San Antonio, TX 78232-2349
Phone
(210) 545-4772
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8659TG TX
Optometrist 152W00000X 8659T TX Primary

Addresses

Primary practice location

16793 San Pedro Ave
San Antonio, TX 78232-2349

Mailing address

16793 San Pedro Ave
San Antonio, TX 78232-2349
Phone (210) 668-8005

Other practice location 1

346 Brees Blvd
San Antonio, TX 78209-4826
Phone (210) 668-8005

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
I20151202000961 TX Practitioner - Optometry 7113227893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16793 San Pedro Ave
San Antonio, TX 78232-2349
Phone (210) 545-4772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8659TTXMDOptometrist
8659TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Vision Associates, P.a. Optometrist CurrentSince Jun 1, 2016 Accepting new patients
Amb Vision Associates PLLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
DRS. Bell, Davis, Elder & Assoc Optometrist Past Accepting new patients
Charlene L. Haynes PastSince Aug 25, 2024 Accepting new patients

Locations

16793 San Pedro Ave
San Antonio, TX 78232
Phone (210) 545-4772

5212 Broadway
San Antonio, TX 78209
Phone (210) 822-7239

Organizations & group practices 4

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1417339581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16793 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322349",
            "telephone_number": "210-668-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16793 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322349",
            "telephone_number": "210-545-4772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "346 Brees Blvd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782094826",
            "country_code": "US",
            "telephone_number": "210-668-8005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "ANNA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8659TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8659T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.