Individual provider Active NPI

Casey Dawn Outlaw, OD

  • Optometrist
  • Conroe, TX
National Provider Identifier
1689169849
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9419T Issued in TX
Practice address
400 S Loop 336 W
Conroe, TX 77304-3302
Phone
(936) 539-4500
Fax
(936) 539-4050
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 9419T TX Primary

Addresses

Primary practice location

400 S Loop 336 W
Conroe, TX 77304-3302

Mailing address

100 Detering St Apt 2134
Houston, TX 77007-1384

Other practice location 1

14700 Fm 2100 Rd Ste 3
Crosby, TX 77532-9162
Phone (281) 328-2020

Other practice location 2

3361 Montgomery Rd
Huntsville, TX 77340-6416
Phone (936) 539-4500

Other practice location 3

129 Vision Park Blvd Ste 110
Shenandoah, TX 77384-3024
Phone (936) 539-4500

Other identifiers 1

IdentifierTypeStateIssuer
433634901MedicaidTX

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
I20181203001240 TX Practitioner - Optometry 4688918600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dejean and Kuglen Eye Associates LLPGroup PAC ID 8527041128, 9 clinicians

Practice addresses (Care Compare)

400 S Loop 336
Conroe, TX 77304-3302
Phone (936) 539-4500

Merit-based Incentive Payment System (MIPS)

Final score
90.63 of 100Reported as group
Quality
95.33
Improvement activities
40
Cost
74.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9419TXMDGeneral Practice Dentistry
9419TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dejean & Kuglen Eye Associates, LLP CurrentSince Mar 1, 2022 Accepting new patients
Dejean & Kuglen Eye Associates LLP CurrentSince Mar 1, 2022 Accepting new patients

Locations

400 S Loop 336 W
Conroe, TX 77304
Phone (406) 539-4500

3361 Montgomery Rd
Huntsville, TX 77340
Phone (936) 539-4500

129 Vision Park Blvd
Ste 110
Shenandoah, TX 77384
Phone (936) 539-4500

Interoperability endpoints

  • Direct secure messaging: coutlaw@averyeye.emadirect.md

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1689169849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DETERING ST APT 2134",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770071384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043302",
            "telephone_number": "936-539-4500",
            "fax_number": "936-539-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14700 Fm 2100 Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Crosby",
            "state": "TX",
            "postal_code": "775329162",
            "country_code": "US",
            "telephone_number": "281-328-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3361 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "TX",
            "postal_code": "773406416",
            "country_code": "US",
            "telephone_number": "936-539-4500",
            "fax_number": "936-539-4050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "129 Vision Park Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773843024",
            "country_code": "US",
            "telephone_number": "936-539-4500",
            "fax_number": "936-539-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "CASEY",
        "middle_name": "DAWN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9419T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433634901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.