NPIMap

Organization Active NPI

Coastal Eye Associates, PLLC

  • Ophthalmology Physician
  • Texas City, TX
National Provider Identifier
1467586776
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
COASTAL EYE ASSOCIATES, PLLC
Practice address
6807 Emmett F Lowry Expy
Suite 102
Texas City, TX 77591-2546
Phone
(281) 488-7213
Fax
(409) 945-3988
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Authorized official

Name
Mr. Kelly Ferree
Title
Executive Administrator
Phone
(281) 488-7213

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

6807 Emmett F Lowry Expy
Suite 102
Texas City, TX 77591-2546

Mailing address

555 E Medical Center Blvd Ste 101
Webster, TX 77598-4367
Phone (281) 488-7213

Other identifiers 2

IdentifierTypeStateIssuer
121767108MedicaidTX
45D2057001OtherTXCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050412000737 TX Part B Supplier - Clinic/Group Practice 2264479112 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Webster, TX; Houston, TX; Texas City, TX; Alvin, TX; Pasadena, TX

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

6807 Emmett F Lowry Expy
Ste 102
Texas City, TX 77591
Phone (409) 945-2269

555 E Medical Center Blvd
Ste 101
Webster, TX 77598
Phone (281) 488-7213

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1467586776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E MEDICAL CENTER BLVD STE 101",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984367",
            "telephone_number": "281-488-7213",
            "fax_number": "281-488-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6807 EMMETT F LOWRY EXPY",
            "address_2": "SUITE 102",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912546",
            "telephone_number": "281-488-7213",
            "fax_number": "409-945-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "FERREE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "281-488-7213",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121767108",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2057001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.