Individual provider Active NPI

Kia Eldred, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1427056787
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3777T Issued in TX
Practice address
505 J Davis Armistead BLDG
4901 Calhoun
Houston, TX 77204-2020
Phone
(713) 743-1921
Fax
(713) 743-0963
NPI assigned
Jul 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3777T TX Primary

Addresses

Primary practice location

505 J Davis Armistead BLDG
4901 Calhoun
Houston, TX 77204-2020

Mailing address

505 J Davis Armistead BLDG
4901 Calhoun
Houston, TX 77204-2020
Phone (713) 743-1921

Other identifiers 1

IdentifierTypeStateIssuer
037174201MedicaidTX

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
I20100608000780 TX Practitioner - Optometry 9436289048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse for the Blind of HoustonGroup PAC ID 2961549811, 3 clinicians

Practice addresses (Care Compare)

3602 W Dallas St
Houston, TX 77019-1704
Phone (713) 284-8494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3777TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse for the Blind of Houston CurrentSince Apr 1, 2016 Accepting new patients
University of Houston System Optometrist Past Accepting new patients

Locations

3602 W Dallas St
Houston, TX 77019
Phone (713) 284-8404

Interoperability endpoints

  • Direct secure messaging: kia.eldred.1@18059.direct.athenahealth.com

Organizations & group practices 2

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1427056787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 J DAVIS ARMISTEAD BLDG",
            "address_2": "4901 CALHOUN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-1921",
            "fax_number": "713-743-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 J DAVIS ARMISTEAD BLDG",
            "address_2": "4901 CALHOUN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-1921",
            "fax_number": "713-743-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRED",
        "first_name": "KIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3777T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037174201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.