Matt Terwillegar, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5627T Issued in TX

Practice address

2200 Briarcrest Dr Ste 106
Bryan, TX 77802-5001

Phone

(979) 774-5400

Fax

(979) 731-8483

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bryan Total Vision Care

  • Optometrist
  • Bryan, TX
  • NPI 1023265196
  Medicare reassignment

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669598041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BRIARCREST DR STE 106",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025001",
            "telephone_number": "979-774-5400",
            "fax_number": "979-731-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BRIARCREST DR STE 106",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025001",
            "telephone_number": "979-774-5400",
            "fax_number": "979-731-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERWILLEGAR",
        "first_name": "MATT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5627T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tcbryan1 LLC (Texas Care Bryan)
• TCH Pediatric Associates, Inc (TCP Bryan)
• Jennifer Tejada Oller, MD
• Televyde, LLC
• Terry M Jones, MD, PA
• Texas a&M University System Health Science Center
• Texas a&M University System Health Science Center (Texas A&M Physicians)
• Texas a&M University System Health Science Center (Texas A&M University School of Nursing Mobile Clinic)
• Texas Avenue Medical Clinic
• Texas Cardiac Arrhythmia PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.