Individual provider Active NPI

Jane Song Kosin, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1487030631
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8759T Issued in TX
Practice address
15900 La Cantera Pkwy Ste 20115
San Antonio, TX 78256-2590
Phone
(210) 354-2020
Fax
(956) 630-0149
NPI assigned
Aug 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8759T TX Primary

Addresses

Primary practice location

15900 La Cantera Pkwy Ste 20115
San Antonio, TX 78256-2590

Mailing address

PO Box 2706
McAllen, TX 78502-2706
Phone (956) 661-9000

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
I20160307001691 TX Practitioner - Optometry 4880990506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey L. Morer, OD, PAGroup PAC ID 2466405394, 11 clinicians
Fox and Sheppard, P.a.Group PAC ID 7810270394, 4 clinicians

Practice addresses (Care Compare)

2413 E Loop 820
Healthdrive Eye Care Group
Fort Worth, TX 76118-6933
Phone (888) 964-6681

4400 Fredericksburg Rd
Suite 107
San Antonio, TX 78201-1969
Phone (210) 737-1926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8759TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox and Sheppard, P.a. Optometrist CurrentSince Feb 6, 2018 Accepting new patients
William Justus Head MD PA Past Accepting new patients

Locations

4400 Fredericksburg Rd
Ste 107
San Antonio, TX 78201
Phone (210) 737-1926

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1487030631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2706",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785022706",
            "telephone_number": "956-661-9000",
            "fax_number": "956-630-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 LA CANTERA PKWY STE 20115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782562590",
            "telephone_number": "210-354-2020",
            "fax_number": "956-630-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSIN",
        "first_name": "JANE",
        "middle_name": "SONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8759T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.