Individual provider Active NPI

Aaron Tyler Wolf, O.D.

  • Optometrist
  • Austin, TX
National Provider Identifier
1427289545
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7430TG Issued in TX
Practice address
8105 Shoal Creek Blvd Ste a
Austin, TX 78757-8040
Phone
(512) 454-4641
Fax
(512) 454-1265
NPI assigned
Aug 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7430TG TX Primary

Addresses

Primary practice location

8105 Shoal Creek Blvd Ste a
Austin, TX 78757-8040

Mailing address

8105 Shoal Creek Blvd Ste a
Austin, TX 78757-8040
Phone (512) 454-4641

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
I20091123000484 TX Practitioner - Optometry 3476692914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Awod PLLCGroup PAC ID 6608116751, 2 clinicians

Practice addresses (Care Compare)

8105 Shoal Creek Blvd
Suite a
Austin, TX 78757-8040
Phone (512) 454-4641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7430TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Awod, PLLC Optometrist CurrentSince Nov 15, 2015 Accepting new patients
McCormick Vision PC Optometrist CurrentSince Feb 6, 2017 Accepting new patients
Lester R Kitchen Optometrist Inc Optometrist PastSince Jun 18, 2018 Accepting new patients
Bob Joe, O.D. and Associates Optometrist PastSince Nov 15, 2015 Accepting new patients
Mallory Lynch, OD, PLLC Optometrist PastSince Oct 1, 2018 Accepting new patients

Locations

12701 Research Blvd
Ste 101
Austin, TX 78759
Phone (512) 258-2020

8105 Shoal Creek Blvd
#A
Austin, TX 78757
Phone (512) 454-4641

Organizations & group practices 5

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": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1427289545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8105 SHOAL CREEK BLVD STE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787578040",
            "telephone_number": "512-454-4641",
            "fax_number": "512-454-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8105 SHOAL CREEK BLVD STE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787578040",
            "telephone_number": "512-454-4641",
            "fax_number": "512-454-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "AARON",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7430TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.