Individual provider Active NPI

Garrett Wentz, OD

  • Optometrist
  • Lubbock, TX
National Provider Identifier
1699294280
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9367T Issued in TX
Practice address
4015 84TH St
Lubbock, TX 79423-1913
Phone
(806) 798-2020
NPI assigned
Sep 14, 2017
Last updated
Apr 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9367T TX Primary

Addresses

Primary practice location

4015 84TH St
Lubbock, TX 79423-1913

Mailing address

3104 Indiana Ave
Lubbock, TX 79410-3148
Phone (806) 793-1927

Other identifiers 1

IdentifierTypeStateIssuer
9367TOtherTXSTATE LICENSE

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
I20171004002689 TX Practitioner - Optometry 1658646476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wentz and Woodrich PLLCGroup PAC ID 5991131955, 5 clinicians

Practice addresses (Care Compare)

4015 84TH St
Lubbock, TX 79423-1913
Phone (806) 798-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9367TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wentz and Woodrich PLLC Optometrist CurrentSince Aug 8, 2019 Accepting new patients

Locations

4015 84th St
Lubbock, TX 79423
Phone (806) 798-2020

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, 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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1699294280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794103148",
            "telephone_number": "806-793-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 84TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231913",
            "telephone_number": "806-798-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZ",
        "first_name": "GARRETT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9367T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "9367T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.