Individual provider Active NPI

Thomas Kozlowski, OD

  • Optometrist
  • Austin, TX
National Provider Identifier
1730567140
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10107 Issued in TX
Practice address
11645 Angus Rd Ste 5
Austin, TX 78759-4020
Phone
(512) 345-5641
Fax
(512) 345-0863
NPI assigned
May 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10107 TX Primary
Optometrist 152W00000X 672 NM

Addresses

Primary practice location

11645 Angus Rd Ste 5
Austin, TX 78759-4020

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20201222002259 TX Practitioner - Optometry 0648682328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

1929 W State Hwy 46
Suite 103
New Braunfels, TX 78132-5337
Phone (830) 524-8870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
672NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Mar 29, 2021 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Catherine K Kennedy Optmetrists PC Optometrist CurrentSince Oct 20, 2020 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Mar 29, 2021 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

15004 Avery Ranch Blvd
Ste 103
Austin, TX 78717
Phone (512) 255-7070

11645 Angus Rd
Ste 5
Austin, TX 78759
Phone (512) 345-5641

714 Congress Ave
Ste 100
Austin, TX 78701
Phone (512) 477-9000

11645 Angus Rd
Ste A5
Austin, TX 78759

6725 Delaware St
Beaumont, TX 77706
Phone (409) 832-9151

6446 Lyndon B Johnson Fwy
Dallas, TX 75240
Phone (972) 960-2020

433 Sportsplex Dr
Ste 100
Dripping Springs, TX 78620
Phone (512) 858-0020

5224 S State Highway 360
Ste 200
Grand Prairie, TX 75052
Phone (972) 602-4545

6127 FM 1960 Rd W
Houston, TX 77069
Phone (281) 469-2020

3032 N Eastman Rd
Ste 100
Longview, TX 75605
Phone (903) 663-2020

1929 State Highway 46 W
Ste 103
New Braunfels, TX 78132
Phone (830) 524-8870

2006 N Main St
Pearland, TX 77581
Phone (281) 485-5591

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8329 Whitley Rd
Watauga, TX 76148
Phone (817) 431-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1730567140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 ANGUS RD STE 5",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594020",
            "telephone_number": "512-345-5641",
            "fax_number": "512-345-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-18",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10107",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.