Individual provider Active NPI

William Thomas Kittleman, M.D.

  • Ophthalmology Physician
  • Round Rock, TX
National Provider Identifier
1528060241
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
F9675 Issued in TX
Practice address
2120 Round Rock Ave Ste 100
Round Rock, TX 78681-4010
Phone
(502) 244-1991
Fax
(512) 244-1786
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X F9675 TX Primary

Addresses

Primary practice location

2120 Round Rock Ave Ste 100
Round Rock, TX 78681-4010

Mailing address

2120 Round Rock Ave Ste 100
Round Rock, TX 78681-4010
Phone (502) 244-1991

Other practice location 1

603 Mallard Ln
Taylor, TX 76574-1214
Phone (512) 352-7664

Other identifiers 1

IdentifierTypeStateIssuer
123221703MedicaidTX

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000372 TX Practitioner - Ophthalmology 4284797358

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
91.81
Improvement activities
40
Cost
78.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F9675TXMDOphthalmology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1528060241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 ROUND ROCK AVE STE 100",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814010",
            "telephone_number": "502-244-1991",
            "fax_number": "512-244-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 ROUND ROCK AVE STE 100",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814010",
            "telephone_number": "502-244-1991",
            "fax_number": "512-244-1786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 Mallard Ln",
            "address_purpose": "LOCATION",
            "city": "Taylor",
            "state": "TX",
            "postal_code": "765741214",
            "country_code": "US",
            "telephone_number": "512-352-7664",
            "fax_number": "512-365-5237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITTLEMAN",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F9675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123221703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.