Roger Wayne Young, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3548T Issued in TX

Practice address

8700 Central Mall Drive
Port Arthur, TX 77642-8058

Phone

(409) 722-6141

Fax

(409) 724-2405

NPI assigned

Oct 31, 2005

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

Practice roles

Locations

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.

• Barry J Davis & Don a Reeves PTR

  • Optometrist
  • Port Arthur, TX
  • NPI 1962528158
  NPD Authorized official

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1689665630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 CENTRAL MALL DRIVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428058",
            "telephone_number": "409-722-6141",
            "fax_number": "409-724-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 CENTRAL MALL DRIVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428058",
            "telephone_number": "409-722-6141",
            "fax_number": "409-724-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROGER",
        "middle_name": "WAYNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3548T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard L Woodcroft, PA
• Matresa Lea Wooding, LCSW
• Lindsay Salter Wortham, MOT, OTR
• Young Men'S Christian Association of Southeast Texas
• Jaycie Young, OT

• Optometrist in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.