Juanita Vincenty, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

7470T Issued in TX

Practice address

7108 Camp Bowie Blvd
Fort Worth, TX 76116-7121

Phone

(817) 738-3191

Fax

(817) 738-7724

NPI assigned

Dec 1, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Luck Optical LLCGroup PAC ID 8426285370, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Luck Optical LLC

  • Optometrist
  • Fort Worth, TX
  • NPI 1871926857
  Medicare reassignment Care Compare group NPD

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY BOARD",
            "identifier": "7470T",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Villegas
• Whitney Johnson Villegas, AG-ACNP
• Andrea Villescas
• Vincent Lewis Medical, PA
• Victoria L Vincent, RN
• Vine Transportation LLC
• Vine Urgent Care PLLC
• Lauren Michelle Vines, LCSW
• Melissa Jean Vines
• Christina Jane Vineyard, RN-IBCLC

• Optometrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optometrist in Texas

• 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.

Verify at the official NPI Registry.