Individual provider Active NPI

William Thomas McGlathery IV, MD

  • Ophthalmology Physician
  • Austin, TX
National Provider Identifier
1659329555
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M3639 Issued in MO
Practice address
4207 James Casey St
Suite 305
Austin, TX 78745-1193
Phone
(512) 447-6096
Fax
(512) 447-2247
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X M3639 MO Primary

Addresses

Primary practice location

4207 James Casey St
Suite 305
Austin, TX 78745-1193

Mailing address

4207 James Casey St
Suite 305
Austin, TX 78745-1193
Phone (512) 447-6096

Other identifiers 2

IdentifierTypeStateIssuer
190111801MedicaidTX
8W540OtherTXBCBS

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070208000585 TX Practitioner - Ophthalmology 2961463146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Mississippi School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peter Broberg,MD and Associates,PAGroup PAC ID 9234182841, 4 clinicians

Practice addresses (Care Compare)

4207 James Casey St
Suite 305
Austin, TX 78745-1193
Phone 5124476096107

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M3639MOMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Broberg, MD and Associates, PA Ophthalmology CurrentSince Oct 1, 2006 Accepting new patients

Locations

4207 James Casey St
Ste 306
Austin, TX 78745
Phone (512) 447-6096

4207 James Casey St
Ste 305
Austin, TX 78745
Phone (512) 447-6096

Organizations & group practices 1

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1659329555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 JAMES CASEY ST",
            "address_2": "SUITE 305",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451193",
            "telephone_number": "512-447-6096",
            "fax_number": "512-447-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 JAMES CASEY ST",
            "address_2": "SUITE 305",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451193",
            "telephone_number": "512-447-6096",
            "fax_number": "512-447-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLATHERY",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "M3639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190111801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8W540",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.