Individual provider Active NPI

Kelly Nhu Mai, O.D.

  • Optometrist
  • Cypress, TX
National Provider Identifier
1487742086
Registry record updated Sep 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7006TG Issued in TX
Practice address
10615 Fry Rd Ste 500
Cypress, TX 77433-6978
Phone
(281) 393-0023
Fax
(832) 653-2439
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7006TG TX Primary

Addresses

Primary practice location

10615 Fry Rd Ste 500
Cypress, TX 77433-6978

Mailing address

19514 Lake Fork CT
Cypress, TX 77433-6319
Phone (832) 483-6952

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Crystalpm Health Information Exchange (HIE)

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
I20070212000521 TX Practitioner - Optometry 9830191352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10615 Fry Rd
Suite 500
Cypress, TX 77433-6978
Phone (281) 393-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7006TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Quest PA Optometrist CurrentSince Jan 1, 2007 Accepting new patients

Locations

203 Highway 290 W
Brenham, TX 77833
Phone (979) 323-8600

10615 Fry Rd
Ste 500
Cypress, TX 77433
Phone (281) 393-0023

Organizations & group practices 1

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1487742086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19514 LAKE FORK CT",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336319",
            "telephone_number": "832-483-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10615 FRY RD STE 500",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336978",
            "telephone_number": "281-393-0023",
            "fax_number": "832-653-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "KELLY",
        "middle_name": "NHU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7006TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Crystalpm",
            "affiliation": "N",
            "endpointDescription": "patientportal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10615 Fry Rd Ste 500",
            "city": "Cypress",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774336978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.