Kevin Soong, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9183-TG Issued in TX

Practice address

3419 El Salido Pkwy Ste 100
Cedar Park, TX 78613-5639

Phone

(512) 918-3937

Fax

(512) 918-2028

NPI assigned

Jul 5, 2017

Last updated

Jul 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeline Vision, P.C.Group PAC ID 0244227486, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lakeline Vision, P.C.

  dba Lakeline Vision Source

  • Optometrist
  • Cedar Park, TX
  • NPI 1265489777
  Medicare reassignment Care Compare group NPD
• Waterloo Eye Associates

  dba Hill Country Eye Center

  • Ophthalmology Physician
  • Cedar Park, TX
  • NPI 1407826415

  Optometrist

  Medicare reassignment NPD
• Clear Eye & Optical Flower Mound PLLC

  • Optometrist
  • Lewisville, TX
  • NPI 1659081917
  NPD (past)

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1528589017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 MILL RUN BND",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652776",
            "telephone_number": "412-913-6819",
            "fax_number": "512-918-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 EL SALIDO PKWY STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135639",
            "telephone_number": "512-918-3937",
            "fax_number": "512-918-2028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11901 W Parmer Ln Ste 400",
            "address_purpose": "LOCATION",
            "city": "Cedar Park",
            "state": "TX",
            "postal_code": "786137655",
            "country_code": "US",
            "telephone_number": "512-528-1144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOONG",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003032",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9183-TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA OPTOMETRY LICENSE",
            "identifier": "OPT003032",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX OPTOMETRY LICENSE",
            "identifier": "9183-TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trisha Sommer, PT
• Savannah Leigh Sommerhalder, M.D.
• Hanna Son
• Sonrisas Dental Center
• Peter C Soo, MD
• Sanjaya P Sooriarachchi, MD
• Kolton Sorensen, HIS
• Jessica Sorgi
• Laurie Lyn Sorrenson, O.D.
• Loubriel Sosa

• Optometrist in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.