Individual provider Active NPI

Samantha Devlin

  • Optometrist
  • Dallas, TX
National Provider Identifier
1750732616
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9307T Issued in TX
Practice address
6185 Retail Rd
Dallas, TX 75231-7807
Phone
(479) 381-5376
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9307T TX Primary
Optometrist 152W00000X 2739 AR

Addresses

Primary practice location

6185 Retail Rd
Dallas, TX 75231-7807

Mailing address

659 Junction Dr Apt D409
Allen, TX 75013-5070
Phone (479) 381-5376

Other practice location 1

1127 S Gutensohn Rd Ste 101
Springdale, AR 72762-5189
Phone (479) 750-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20180626001471 AR Practitioner - Optometry 0648545475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boozman-Hof Regional Eye Clinic PAGroup PAC ID 4981628245, 12 clinicians

Practice addresses (Care Compare)

3737 W Walnut St
Rogers, AR 72756-1839
Phone (479) 246-1700

Merit-based Incentive Payment System (MIPS)

Final score
92.75 of 100Reported as group
Quality
99.17
Improvement activities
40
Cost
76.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2739ARMDDentist
9307TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Boozman-Hof Regional Eye Clinic PA Optometrist CurrentSince May 14, 2018 Accepting new patients
Thomason Eye Care, P.a. Optometrist PastSince Aug 1, 2009 Accepting new patients
Boozman-Hof Regional Eye Clinic PA Past Accepting new patients
Boozman-Hof Regional Eye Clinic Optometrist Past Accepting new patients

Locations

25 Cunningham Cor
Bella Vista, AR 72714
Phone (479) 246-1700

3737 W Walnut St
Rogers, AR 72756
Phone (479) 246-1700

Interoperability endpoints

  • Direct secure messaging: sdevlin@bhrec.intellechartdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750732616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 JUNCTION DR APT D409",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135070",
            "telephone_number": "479-381-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6185 RETAIL RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752317807",
            "telephone_number": "479-381-5376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1127 S Gutensohn Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727625189",
            "country_code": "US",
            "telephone_number": "479-750-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVLIN",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9307T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.