Sally Salamata Hamissou, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8017 Issued in TX

Practice address

3601 W William Cannon Dr Ste 150
Austin, TX 78749-1547

Phone

(512) 442-2308

NPI assigned

Jul 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 Alabama Birmingham - School of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Berg En Dal PLLCGroup PAC ID 3779682018, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Berg En Dal PLLC

  dba Jansen Optical

  • Optometrist
  • Austin, TX
  • NPI 1740373141
  Medicare reassignment Care Compare group NPD Authorized official
• Berg En Dal PLLC

  dba Jansen Optical

  • Optometrist
  • Austin, TX
  • NPI 1881787281
  NPD Authorized official

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1548515364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W WILLIAM CANNON DR STE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W WILLIAM CANNON DR STE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491547",
            "telephone_number": "512-442-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMISSOU",
        "first_name": "SALLY",
        "middle_name": "SALAMATA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Juliet Hamilton, FNP
• Stacey Hamilton, RN,GNP
• Steffani Hamilton, RN, BSN
• Tara Lynn Hamilton, NNP-BC, PMHNP-BC
• Trevor Alexander Hamilton, DDS
• Brianna Hamlyn, LPC
• Renee Hamm-Bennett, M.A., LPC-INTERN
• Cherylynn Hamm-Dotson, MASSAGE THERAPIST
• Lindsey Hamm, M.S., BCBA
• Isabelle Hammack-Traille, RD

• Optometrist in Austin, TX
• Providers in Austin, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.