Individual provider Active NPI

Matthew C Snyder, OD

  • Optometrist
  • Montgomery, TX
National Provider Identifier
1487650628
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5751TG Issued in TX
Practice address
123 Blue Heron Dr
Ste 103
Montgomery, TX 77316-3192
Phone
(936) 582-4200
Fax
(936) 582-2323
NPI assigned
Jun 22, 2005
Reactivated
Mar 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5751TG TX Primary

Addresses

Primary practice location

123 Blue Heron Dr
Ste 103
Montgomery, TX 77316-3192

Mailing address

PO Box 405
Montgomery, TX 77356-0405
Phone (936) 582-4200

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
I20070518000237 TX Practitioner - Optometry 2769589225 Reassigns benefits to 1 organization
Practice locations: Montgomery, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

123 Blue Heron Dr
Suite 103
Montgomery, TX 77316-3192
Phone (936) 851-1649

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5751TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Eye Associates PC Optometrist CurrentSince Jul 1, 2017 Accepting new patients
Cooper Clinic PA Past Accepting new patients

Locations

123 Blue Heron Dr
Ste 103
Montgomery, TX 77316
Phone (936) 448-4200

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487650628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773560405",
            "telephone_number": "936-582-4200",
            "fax_number": "936-582-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "address_2": "STE 103",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-582-4200",
            "fax_number": "936-582-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5751TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

Verify at the official NPI Registry.