Individual provider Active NPI

Jennifer Khanh, O.D.

  • Optometrist
  • Austin, TX
National Provider Identifier
1770730921
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7270T Issued in TX
Practice address
9900 W Parmer LN
Ste. 210
Austin, TX 78717-4909
Phone
(512) 339-2020
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7270T TX Primary

Addresses

Primary practice location

9900 W Parmer LN
Ste. 210
Austin, TX 78717-4909

Mailing address

12215 Hunters Chase Dr
Apt #6208
Austin, TX 78729-7255

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
I20081202000265 TX Practitioner - Optometry 5496816050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifetime Vision Care Texas PLLCGroup PAC ID 2668783150, 2 clinicians

Practice addresses (Care Compare)

408 N Mays St
Round Rock, TX 78664-4317
Phone (512) 244-2003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7270TXMDChiropractor
7270TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Vision Care Texas, PLLC Optometrist CurrentSince Apr 19, 2015 Accepting new patients
Lifetime Vision Care PA Optometrist PastSince Apr 19, 2015 Accepting new patients
Optometric Associates of Texas P.a. Optometrist PastSince Oct 16, 2022 Accepting new patients
Med Southwest, PLLC Optometrist Past Accepting new patients

Locations

408 N Mays St
Round Rock, TX 78664
Phone (512) 244-2003

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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1770730921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12215 HUNTERS CHASE DR",
            "address_2": "APT #6208",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787297255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 W PARMER LN",
            "address_2": "STE. 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174909",
            "telephone_number": "512-339-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANH",
        "first_name": "JENNIFER",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7270T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.