Boerne Vision Center PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BOERNE VISION CENTER PA

Practice address

124 E Bandera Rd
Suite 403
Boerne, TX 78006-2849

Phone

(830) 331-8745

Fax

(830) 331-8749

NPI assigned

Feb 21, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Susan Ly Johnson, ODNPI 1235683889

Title

Owner/Authorized Official

Phone

(830) 331-8745

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Susan Ly Johnson, O.D.

  • Optometrist
  • Boerne, TX
  • NPI 1235683889
  Medicare reassignment Care Compare group NPD Authorized official
• Aum Nitin Patel, O.D.

  • Optometrist
  • Keller, TX
  • NPI 1538773510
  Medicare reassignment Care Compare group NPD
• Rebecca Anne Sheeder, O.D.

  • Optometrist
  • Lake City, FL
  • NPI 1255888798

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1609149731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E BANDERA RD",
            "address_2": "SUITE 403",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062849",
            "telephone_number": "830-331-8745",
            "fax_number": "830-331-8749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E BANDERA RD",
            "address_2": "SUITE 403",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062849",
            "telephone_number": "830-331-8745",
            "fax_number": "830-331-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOERNE VISION CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LY",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "830-331-8745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376409401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boerne Physical Therapy Institute
• Boerne Regen and Anti-Aging Center, PLLC
• Boerne Spectrum Physical Therapy Clinic (Spectrum Physical Therapy)
• Boerne Speech Therapy, LLC (Trio Rehabilitation & Wellness Solutions)
• Boerne TX Familty Dentistry PLLC (Boerne Family Dentistry)
• Boerne Wellness Chiropractic, P. a.
• Boerne Women's Care, PLLC
• Boerne's Little Smiles Dentistry for Children, PLLC
• Boerne's Little Smiles Dentistry for Children, PLLC
• Shalini Boggarapu, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.