Organization Active NPI

Tom Annunziato, OD PC

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1740317973
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TOM ANNUNZIATO, OD PC
Practice address
3608 Altamesa Blvd
Fort Worth, TX 76133-5641
Phone
(817) 346-2020
Fax
(817) 370-1655
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Tom Annunziato, OD
Title
Owner OD
Phone
(817) 346-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3608 Altamesa Blvd
Fort Worth, TX 76133-5641

Mailing address

3608 Altamesa Blvd
Fort Worth, TX 76133-5641
Phone (817) 346-2020

Other names 1

  • 1st Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001228 TX Part B Supplier - Clinic/Group Practice 7315836368 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Fort Worth, TX; Weatherford, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3608 Altamesa Blvd
Ft Worth, TX 76133
Phone (817) 294-0877

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1740317973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761335641",
            "telephone_number": "817-346-2020",
            "fax_number": "817-370-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761335641",
            "telephone_number": "817-346-2020",
            "fax_number": "817-370-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM ANNUNZIATO, OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "ANNUNZIATO",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "OWNER  OD",
        "authorized_official_telephone_number": "817-346-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.