Organization Active NPI

Coastal Vision Care, PC

  • Optometrist
  • Aransas Pass, TX
National Provider Identifier
1548608383
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6902TG Issued in TX
Legal business name
COASTAL VISION CARE, PC
Practice address
2501 W Wheeler Ave
Aransas Pass, TX 78336-5916
Phone
(361) 758-3433
Fax
(361) 758-3424
NPI assigned
Jun 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Authorized official

Name
Dr. Amanda R Martini, O.D.NPI 1053448746
Title
Owner
Phone
(361) 758-3433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 6902TG TX Primary

Addresses

Primary practice location

2501 W Wheeler Ave
Aransas Pass, TX 78336-5916

Mailing address

2501 W Wheeler Ave
Aransas Pass, TX 78336-5916
Phone (361) 758-3433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131113000867 TX Part B Supplier - Clinic/Group Practice 0941436356 Receives reassigned benefits from 1 practitioner
Practice locations: Aransas Pass, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1548608383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W WHEELER AVE",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "783365916",
            "telephone_number": "361-758-3433",
            "fax_number": "361-758-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W WHEELER AVE",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "783365916",
            "telephone_number": "361-758-3433",
            "fax_number": "361-758-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL VISION CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "MARTINI",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-758-3433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6902TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aransas Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.