Individual provider Active NPI

David Lee McDonald, OD

  • Optometrist
  • Henderson, TX
National Provider Identifier
1457433245
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5144TG Issued in TX
Practice address
1787 US Hwy 79 S
Henderson, TX 75654
Phone
(903) 657-1539
Fax
(903) 657-0259
NPI assigned
Oct 20, 2006
Last updated
Jun 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5144TG TX Primary

Addresses

Primary practice location

1787 US Hwy 79 S
Henderson, TX 75654

Mailing address

1787 US Hwy 79 S
Henderson, TX 75654
Phone (903) 657-1539

Other identifiers 3

IdentifierTypeStateIssuer
110677504MedicaidTX
142624902OtherTXMEDICAID GROUP
00Z051OtherTXMEDICARE GROUP

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
I20080519000499 TX Practitioner - Optometry 6103995014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1787 Hwy 79 S
Henderson, TX 75654-4509

1787 US Hwy 79 S
Henderson, TX 75654-4509
Phone (903) 657-1539

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5144TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Eye Association, Inc Optometrist CurrentSince Jan 1, 2007 Accepting new patients
Henderson Eye Associates Optometrist Past Accepting new patients

Locations

1787 US Highway 79 S
Henderson, TX 75654
Phone (903) 657-1539

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, 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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1457433245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1787 US HWY 79 S",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "75654",
            "telephone_number": "903-657-1539",
            "fax_number": "903-657-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 US HWY 79 S",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "75654",
            "telephone_number": "903-657-1539",
            "fax_number": "903-657-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5144TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110677504",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "142624902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "00Z051",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TX

Sources for this page

Verify at the official NPI Registry.