Individual provider Active NPI

Ladan Mohtadi Rouhani, O.D.

  • Optometrist
  • Frisco, TX
National Provider Identifier
1487719274
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8377T Issued in TX
Practice address
8380 Warren Pkwy
Ste 605
Frisco, TX 75034-4253
Phone
(972) 668-3131
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8377T TX Primary
Optometrist 152W00000X 12618T CA

Addresses

Primary practice location

8380 Warren Pkwy
Ste 605
Frisco, TX 75034-4253

Mailing address

8380 Warren Pkwy
Ste 605
Frisco, TX 75034-4253

Other practice location 1

3405 Midway Rd Ste 421
Plano, TX 75093-8144
Phone (972) 801-2727

Other names 1

  • Ladan Charlene Mohtadi Former name

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
I20161102000157 TX Practitioner - Optometry 4688602030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12618TCAMDOptometrist
8377TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Apr 1, 2023 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Apr 1, 2023 Accepting new patients
Total Vision PC Optometrist PastSince Feb 4, 2020 Accepting new patients
Pearle Visioncare, Inc Past Accepting new patients
Los Gatos Eye Care a Professional Optometric Corporation Optometrist PastSince Oct 31, 2013 Accepting new patients
Luxottica of America Inc. Past Accepting new patients
J Pietrantonio OD Inc Optometrist PastSince Jan 1, 2005 Accepting new patients

Locations

6446 Lyndon B Johnson Fwy
Dallas, TX 75240
Phone (972) 960-2020

3405 Midway Rd
Ste 421
Plano, TX 75093
Phone (972) 801-2727

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 8

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1487719274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 WARREN PKWY",
            "address_2": "STE 605",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 WARREN PKWY",
            "address_2": "STE 605",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344253",
            "telephone_number": "972-668-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3405 Midway Rd Ste 421",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938144",
            "country_code": "US",
            "telephone_number": "972-801-2727",
            "fax_number": "972-943-3485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUHANI",
        "first_name": "LADAN",
        "middle_name": "MOHTADI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8377T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12618T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LADAN",
            "last_name": "MOHTADI",
            "middle_name": "CHARLENE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.