Individual provider Active NPI

Reena Patel

  • Optometrist
  • Irving, TX
National Provider Identifier
1487175667
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9273 Issued in TX
Practice address
1135 Kinwest Pkwy Ste 100
Irving, TX 75063-3505
Phone
(972) 432-2020
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9273 TX Primary

Addresses

Primary practice location

1135 Kinwest Pkwy Ste 100
Irving, TX 75063-3505

Mailing address

1135 Kinwest Pkwy Ste 100
Irving, TX 75063-3505

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
I20170821001553 TX Practitioner - Optometry 3971875311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9273TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Novabloom LLC Current Accepting new patients
Jonathan Cargo, O.D., P.a. Optometrist CurrentSince Jul 5, 2017 Accepting new patients

Locations

1135 Kinwest Pkwy
Ste 100
Irving, TX 75063
Phone (972) 432-2020

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, 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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1487175667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 KINWEST PKWY STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 KINWEST PKWY STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633505",
            "telephone_number": "972-432-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "REENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.