Individual provider Active NPI

Dawn Matocha, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1467849778
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6448TG Issued in TX
Practice address
1936 SW Military Dr
Suite a
San Antonio, TX 78221-1461
Phone
(210) 932-2092
NPI assigned
Apr 24, 2015
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6448TG TX Primary
Corneal and Contact Management Optometrist 152WC0802X 6448TG TX

Addresses

Primary practice location

1936 SW Military Dr
Suite a
San Antonio, TX 78221-1461

Mailing address

1936 SW Military Dr
Suite a
San Antonio, TX 78221-1461

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
I20240312001384 TX Practitioner - Optometry 7810241312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RCP Eyecare, PCGroup PAC ID 9234474172, 13 clinicians

Practice addresses (Care Compare)

8222 Agora Pkwy
Suite 116
Selma, TX 78154-1319
Phone (210) 659-1479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6448TXMDSchool Psychologist
6448TGTXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
RCP Eyecare, PC Optometrist CurrentSince Feb 19, 2024 Accepting new patients

Locations

15900 La Cantera Pkwy
Ste 9915
San Antonio, TX 78256
Phone (210) 641-2405

6035 NW Loop 410
San Antonio, TX 78238
Phone (210) 520-0335

8222 Agora Pkwy
Ste 116
Selma, TX 78154
Phone (210) 657-6270

8222 Agora Pkwy
Ste 116A
Selma, TX 78154
Phone (210) 659-1479

Organizations & group practices 1

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": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1467849778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 SW MILITARY DR",
            "address_2": "SUITE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 SW MILITARY DR",
            "address_2": "SUITE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211461",
            "telephone_number": "210-932-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOCHA",
        "first_name": "DAWN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6448TG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "6448TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.