Individual provider Active NPI

Thomas Robert Nettleton, OD

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1497108435
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9009T Issued in TX
Practice address
9725 Datapoint Dr Ste 106
San Antonio, TX 78229-2385
Phone
(210) 585-2020
Fax
(210) 249-0209
NPI assigned
Jul 14, 2016
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9009T TX Primary

Addresses

Primary practice location

9725 Datapoint Dr Ste 106
San Antonio, TX 78229-2385

Mailing address

9725 Datapoint Dr Ste 106
San Antonio, TX 78229-2385
Phone (210) 585-2020

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
I20160808001492 TX Practitioner - Optometry 5597059964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refractive Surgery and Diagnostic Center PLLCGroup PAC ID 5496995367, 12 clinicians

Practice addresses (Care Compare)

9725 Datapoint Dr
Suite 106
San Antonio, TX 78229-2385
Phone (210) 615-9358

Merit-based Incentive Payment System (MIPS)

Final score
88.42 of 100Reported as group
Quality
94.48
Improvement activities
40
Cost
68.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9009TXMDProfessional Counselor
9009TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Anestexia LLC CurrentSince Feb 6, 2022 Accepting new patients
Refractive Surgery & Diagnostic Center PLLC Optometrist CurrentSince Nov 1, 2018 Accepting new patients
Jed Lee Howard PA PastSince Jun 27, 2016 Accepting new patients

Locations

9725 Datapoint Dr
Ste 106
San Antonio, TX 78229
Phone (210) 585-2020

9725 Datapoint Dr
Ste 200
San Antonio, TX 78229
Phone (210) 615-9358

Organizations & group practices 3

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1497108435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 DATAPOINT DR STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292385",
            "telephone_number": "210-585-2020",
            "fax_number": "210-249-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 DATAPOINT DR STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292385",
            "telephone_number": "210-585-2020",
            "fax_number": "210-249-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTLETON",
        "first_name": "THOMAS",
        "middle_name": "ROBERT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9009T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.