Active NPI
Thomas William Bandy, O.D.
- Optometrist
- Knoxville, TN
National Provider Identifier
1467557751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 945
- Practice address
- 11289 Parkside Dr
Ste1108
Knoxville, TN 37934 - Phone
- (865) 675-2524
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 945 | TN | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | ODT 945 | TN |
Addresses
Primary practice location
11289 Parkside Dr
Ste1108
Knoxville, TN 37934
Mailing address
11289 Parkside Dr Ste 1108
Knoxville, TN 37934-1964
Phone (865) 675-2524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q019837 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041118000140 | TN | Practitioner - Optometry | 2567426653 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 945 | TN | MD | Professional Counselor |
| ODT 945 | TN | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients |
Interoperability endpoints
- thomas.bandy@direct.revolutionehr.com
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 and National Provider Directory roles.
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dr. Torrey J. Carlson and Associates
Practice addresses (Care Compare)
11289 Parkside Dr
SPC 1108
Knoxville, TN 37934-1964
Phone (865) 675-2524
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534118400000",
"number": "1467557751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11289 PARKSIDE DR STE 1108",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379341964",
"telephone_number": "865-675-2524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11289 PARKSIDE DR",
"address_2": "STE1108",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37934",
"telephone_number": "865-675-2524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDY",
"first_name": "THOMAS",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2018-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "945",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "TN",
"license": "ODT 945",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q019837",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.