Active NPI
Juanita Vincenty, OD
- Optometrist
- Fort Worth, TX
National Provider Identifier
1437487543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7470T
- Practice address
- 7108 Camp Bowie Blvd
Fort Worth, TX 76116-7121 - Phone
- (817) 738-3191
- Fax
- (817) 738-7724
- NPI assigned
- Dec 1, 2009
- Last updated
- Mar 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7470T | TX | Primary |
Addresses
Primary practice location
7108 Camp Bowie Blvd
Fort Worth, TX 76116-7121
Mailing address
7108 Camp Bowie Blvd
Fort Worth, TX 76116-7198
Phone (817) 738-3191
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
7108 Camp Bowie Blvd
Fort Worth, TX 76116-7121
Phone (817) 738-3191
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7470T | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luck Optical LLC | Optometrist | Current | Accepting new patients |
Locations
7108 Camp Bowie Blvd
Ft Worth, TX 76116
Phone (817) 738-3191
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": "1259625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1437487543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 CAMP BOWIE BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761167198",
"telephone_number": "817-738-3191",
"fax_number": "817-738-7724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7108 CAMP BOWIE BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761167121",
"telephone_number": "817-738-3191",
"fax_number": "817-738-7724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENTY",
"first_name": "JUANITA",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-01",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "7470T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.