Individual provider Active NPI

Samir Pattni, O.D

  • Optometrist
  • Plano, TX
National Provider Identifier
1427030717
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4757TG Issued in TX
Practice address
2821 W Parker Rd
Suite 1
Plano, TX 75023-7950
Phone
(972) 596-3800
NPI assigned
Nov 14, 2005
Last updated
Nov 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4757TG TX Primary

Addresses

Primary practice location

2821 W Parker Rd
Suite 1
Plano, TX 75023-7950

Mailing address

2821 W Parker Rd
Suite 1
Plano, TX 75023-7950
Phone (972) 596-3800

Other identifiers 3

IdentifierTypeStateIssuer
0A4530OtherTXMEDICARE GROUP PTAN
8F21704OtherTXMEDICARE PTAN INDIVIDUAL
OOE12YOtherTXMEDICARE PROVIDER NUMBER

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
I20090618000430 TX Practitioner - Optometry 0648320317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2821 W Parker Rd
Suite 1
Plano, TX 75023-7949
Phone (972) 596-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4757TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Collin Creek Eye Clinic P.a Optometrist CurrentSince Jun 18, 2009 Accepting new patients

Locations

2237 W 15th St
Plano, TX 75075
Phone (972) 596-3800

2821 W Parker Rd
Ste 1
Plano, TX 75023
Phone (972) 596-3800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1427030717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 W PARKER RD",
            "address_2": "SUITE 1",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750237950",
            "telephone_number": "972-596-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 W PARKER RD",
            "address_2": "SUITE 1",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750237950",
            "telephone_number": "972-596-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTNI",
        "first_name": "SAMIR",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4757TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "0A4530",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN INDIVIDUAL",
            "identifier": "8F21704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "OOE12Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.