Active NPI
Stephen A Ditta, OD
- Optometrist
- Tomball, TX
National Provider Identifier
1487645552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3624T
- Practice address
- 1231 Alma St
Ste O
Tomball, TX 77375-4501 - Phone
- (281) 351-7378
- Fax
- (281) 255-9597
- NPI assigned
- Oct 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3624T | TX | Primary |
Addresses
Primary practice location
1231 Alma St
Ste O
Tomball, TX 77375-4501
Mailing address
1231 Alma St
Ste O
Tomball, TX 77375-4501
Phone (281) 351-7378
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 760194385 | Other | TX | COMP BENEFITS |
| 760194385 | Other | TX | SUPERIOR VISION |
| 2813517378 | Other | TX | VISION SERVICE PLAN |
| 093346701 | Medicaid | TX | |
| 930127 | Other | TX | BLOCK VISION |
| 760194385 | Other | TX | EYEMED |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110404000316 | TX | Practitioner - Optometry | 0244348787 | Practice locations: Tomball, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402444800000",
"number": "1487645552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1231 ALMA ST",
"address_2": "STE O",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773754501",
"telephone_number": "281-351-7378",
"fax_number": "281-255-9597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1231 ALMA ST",
"address_2": "STE O",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773754501",
"telephone_number": "281-351-7378",
"fax_number": "281-255-9597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DITTA",
"first_name": "STEPHEN",
"middle_name": "A",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-28",
"last_updated": "2014-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "3624T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMP BENEFITS",
"identifier": "760194385",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR VISION",
"identifier": "760194385",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICE PLAN",
"identifier": "2813517378",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "093346701",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK VISION",
"identifier": "930127",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "760194385",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.