Individual provider Active NPI

John M. Nevelow, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1710984067
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2061TG Issued in TX
Practice address
19190 Stone Oak Pkwy
Suite 120
San Antonio, TX 78258-3237
Phone
(210) 349-2437
Fax
(210) 494-1633
NPI assigned
Jul 1, 2005
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2061TG TX Primary
Optometrist 152W00000X MN0265923 TX

Addresses

Primary practice location

19190 Stone Oak Pkwy
Suite 120
San Antonio, TX 78258-3237

Mailing address

19190 Stone Oak Pkwy
Suite 120
San Antonio, TX 78258-3237
Phone (210) 349-2437

Other identifiers 3

IdentifierTypeStateIssuer
741764072OtherTXPROVIDER NUMBER
00E11HOtherTXBLUECROSSBLUESHIELD
2326241OtherTXAETNA

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
I20120306000151 TX Practitioner - Optometry 0941318513 Reassigns benefits to 2 organizations
Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nevelow Eye AssociatesGroup PAC ID 2860774569, 2 clinicians
University of the Incarnate WordGroup PAC ID 9234310301, 25 clinicians

Practice addresses (Care Compare)

19190 Stone Oak Pkwy
San Antonio, TX 78258-3237
Phone (210) 349-2437

9725 Datapoint Dr
San Antonio, TX 78229-2384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2061TXMDBehavioral Analyst
2061TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Incarnate Word Optometrist CurrentSince Oct 16, 2024 Accepting new patients
University of the Incarnate Word CurrentSince Oct 16, 2024 Accepting new patients

Locations

9725 Datapoint Dr
San Antonio, TX 78229
Phone (210) 283-6800

9725 Datapoint Dr
#69
San Antonio, TX 78229
Phone (210) 283-6800

Interoperability endpoints

  • Direct secure messaging: jnevelow@neveloweyea.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 4

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1710984067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19190 STONE OAK PKWY",
            "address_2": "SUITE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583237",
            "telephone_number": "210-349-2437",
            "fax_number": "210-494-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19190 STONE OAK PKWY",
            "address_2": "SUITE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583237",
            "telephone_number": "210-349-2437",
            "fax_number": "210-494-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVELOW",
        "first_name": "JOHN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2061TG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "MN0265923",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "741764072",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "00E11H",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2326241",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.