Individual provider Active NPI

Julie Gorn, O.D.

  • Optometrist
  • Austin, TX
National Provider Identifier
1710112511
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8622T Issued in TX
Practice address
2901 S Capital of Texas Hwy
Austin, TX 78746-8101
Phone
(512) 329-6092
Fax
(512) 330-9941
NPI assigned
May 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006912 NY
Optometrist 152W00000X 8622T TX Primary

Addresses

Primary practice location

2901 S Capital of Texas Hwy
Austin, TX 78746-8101

Mailing address

6303 Mountain Park CV
Austin, TX 78731-2611
Phone (201) 488-0696

Other practice location 1

401 RR 620 S Ste 210
Lakeway, TX 78734-5304
Phone (512) 263-9000

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
I20171205001025 TX Practitioner - Optometry 4486831039 Reassigns benefits to 1 organization
Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5621 N Ih
Suite 35
Austin, TX 78723-2431
Phone (512) 903-5770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006912NYMDOptometrist
8622TTXMDOptometrist
006912NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare of Austin, PLLC Optometrist CurrentSince Sep 12, 2020 Accepting new patients
Lake Travis Eye and Laser Center, PA Past Accepting new patients
Skylight Optical Inc. PastSince Apr 15, 2014 Accepting new patients

Locations

5621 N Interstate 35
Austin, TX 78723
Phone (512) 329-6092

Organizations & group practices 3

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1710112511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6303 MOUNTAIN PARK CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787312611",
            "telephone_number": "201-488-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 S CAPITAL OF TEXAS HWY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787468101",
            "telephone_number": "512-329-6092",
            "fax_number": "512-330-9941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 RR 620 S Ste 210",
            "address_purpose": "LOCATION",
            "city": "Lakeway",
            "state": "TX",
            "postal_code": "787345304",
            "country_code": "US",
            "telephone_number": "512-263-9000",
            "fax_number": "512-263-9126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORN",
        "first_name": "JULIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006912",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8622T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.