Austin Eye Clinic Association

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Austin Eye Clinic Association

  • Ambulatory Surgical Clinic/Center
  • Austin, TX
  • NPI 1952398141

  6608910542

  Same PAC ID

Locations

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.

• Austin Eye Clinic Association

  • Ambulatory Surgical Clinic/Center
  • Austin, TX
  • NPI 1952398141
  NPPES parent name

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon M Wong, MD

  • Ophthalmology Physician
  • Austin, TX
  • NPI 1497753040
  Medicare reassignment Care Compare group NPD Authorized official
• Ashley M Deese, OD

  • Optometrist
  • Austin, TX
  • NPI 1538689112
  Medicare reassignment Care Compare group NPD
• Katherine N Elkins, OD

  • Optometrist
  • Austin, TX
  • NPI 1043707201
  Medicare reassignment Care Compare group NPD
• River Ficke, OD

  • Optometrist
  • Austin, TX
  • NPI 1558140715
  Medicare reassignment Care Compare group NPD
• Charles Maxwell Medert, MD

  • Ophthalmology Physician
  • Austin, TX
  • NPI 1487195608
  Medicare reassignment Care Compare group NPD
• Krista Stewart, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Austin, TX
  • NPI 1295077444

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• Sarah Gene Forrest, O.D.

  • Optometrist
  • Tulsa, OK
  • NPI 1437438629

  TX

  Medicare reassignment Care Compare group
• John David Odette, MD

  • Ophthalmology Physician
  • Austin, TX
  • NPI 1124224464
  Medicare reassignment NPD
• Christina Theresa Wenn, OD

  • Optometrist
  • Austin, TX
  • NPI 1639630320
  Medicare reassignment NPD
• William E McCaleb, M.D.

  • Optometrist
  • Austin, TX
  • NPI 1184622649
  NPD (past)

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00K61V",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083533201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin ER Associates PLLC
• Austin ER, LLC
• Austin Essential Health Care Services, Inc.
• Austin Exclusive Medical Supplies, L.L.C.
• Austin Eye Center PLLC
• Austin Eye Clinic Association
• Austin Family Allergy & Asthma, PA
• Austin Family Care, PLLC
• Austin Family Dental Spa PLLC
• Austin Family Dentistry PPLC

• Ophthalmology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Ophthalmology Physician in Texas

• 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.