NPIMap

Organization Active NPI

Austin Eye Clinic Association

  • Ophthalmology Physician
  • Austin, TX
National Provider Identifier
1457540221
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
AUSTIN EYE CLINIC ASSOCIATION
Practice address
2700 Bee Caves Rd
Austin, TX 78746-5675
Phone
(512) 250-2020
Fax
(512) 250-2612
NPI assigned
Oct 17, 2007
Last updated
Sep 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Authorized official

Name
Shannon Wong, MDNPI 1497753040
Title
Owner
Phone
(512) 250-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2700 Bee Caves Rd
Austin, TX 78746-5675

Mailing address

11901 Jollyville Rd
Austin, TX 78759-2303
Phone (512) 250-2020

Other practice location 1

11901 Jollyville Rd
Austin, TX 78759-2303
Phone (512) 250-2020

Other practice location 2

1009 E 40th Street #200
Austin, TX 78751-4838
Phone (512) 454-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100216000829 TX Part B Supplier - Clinic/Group Practice 6608910542 Receives reassigned benefits from 9 practitioners
Practice locations: Austin, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1009 E 40th St
Ste 200
Austin, TX 78751
Phone (512) 454-2020

2700 Bee Caves Rd
Austin, TX 78746
Phone (512) 250-2020

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1457540221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 JOLLYVILLE RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787592303",
            "telephone_number": "512-250-2020",
            "fax_number": "512-250-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BEE CAVES RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787465675",
            "telephone_number": "512-250-2020",
            "fax_number": "512-250-2612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11901 Jollyville Rd",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787592303",
            "country_code": "US",
            "telephone_number": "512-250-2020",
            "fax_number": "512-250-2612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 E 40th Street #200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787514838",
            "country_code": "US",
            "telephone_number": "512-454-2020",
            "fax_number": "512-454-1681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUSTIN EYE CLINIC ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-250-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.