Individual provider Active NPI

Faye Nicole Tupa, O.D.

  • Optometrist
  • Victoria, TX
National Provider Identifier
1639358229
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6286TG Issued in TX
Practice address
1308 N Main St
Victoria, TX 77901-5911
Phone
(361) 573-2021
Fax
(361) 573-4047
NPI assigned
Oct 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6286TG TX Primary

Addresses

Primary practice location

1308 N Main St
Victoria, TX 77901-5911

Mailing address

1308 N Main St
Victoria, TX 77901-5911
Phone (361) 573-2021

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080305000185 TX Practitioner - Optometry 3870678568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Faye N. Tupa, O.D., P.C.Group PAC ID 7719058833, 2 clinicians

Practice addresses (Care Compare)

1308 N Main St
Victoria, TX 77901-5911
Phone (361) 582-4966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6286TXMDChiropractor
6286TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Faye N. Tupa, O.D., P.C. Optometrist CurrentSince Jan 1, 2008 Accepting new patients
Caia D. Homerstad OD PLLC Optometrist PastSince Jan 1, 2008 Accepting new patients

Locations

3804 John Stockbauer Dr
Ste A
Victoria, TX 77904
Phone (361) 570-2010

1308 N Main St
Victoria, TX 77901
Phone (361) 582-4966

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1639358229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 N MAIN ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015911",
            "telephone_number": "361-573-2021",
            "fax_number": "361-573-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 N MAIN ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015911",
            "telephone_number": "361-573-2021",
            "fax_number": "361-573-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPA",
        "first_name": "FAYE",
        "middle_name": "NICOLE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6286TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.