Individual provider Active NPI

Emily Suzanne Jordan, O.D.

  • Optometrist
  • Hutto, TX
National Provider Identifier
1659668044
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7756TG Issued in TX
Practice address
5002 Gattis School Rd Ste 100
Hutto, TX 78634-2028
Phone
(512) 243-7858
Fax
(512) 243-7835
NPI assigned
Jul 6, 2011
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 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 7756TG TX Primary

Addresses

Primary practice location

5002 Gattis School Rd Ste 100
Hutto, TX 78634-2028

Mailing address

5002 Gattis School Rd Ste 100
Hutto, TX 78634-2028
Phone (512) 243-7858

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
I20120125000748 TX Practitioner - Optometry 9032386495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Focus Vision and Eye Care, PLLCGroup PAC ID 8820373558, 2 clinicians

Practice addresses (Care Compare)

5002 Gattis School Rd
Suite 100
Hutto, TX 78634-2028
Phone (512) 243-7858

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7756TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Vision Group, PLLC Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Focus Vision & Eye Care, PLLC Optometrist CurrentSince Jun 1, 2022 Accepting new patients

Locations

1201 Barbara Jordan Blvd
Ste 1480
Austin, TX 78723
Phone (512) 320-1968

2901 S Loop 360
Ste P6
Austin, TX 78746
Phone (512) 330-9513

5002 Gattis School Rd
Ste 100
Hutto, TX 78634
Phone (512) 243-7858

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1659668044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 GATTIS SCHOOL RD STE 100",
            "city": "HUTTO",
            "state": "TX",
            "postal_code": "786342028",
            "telephone_number": "512-243-7858",
            "fax_number": "512-243-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 GATTIS SCHOOL RD STE 100",
            "city": "HUTTO",
            "state": "TX",
            "postal_code": "786342028",
            "telephone_number": "512-243-7858",
            "fax_number": "512-243-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "EMILY",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7756TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hutto, TX

Sources for this page

Verify at the official NPI Registry.