Active NPI
Bruce M. Goldstick, O.D.
- Optometrist
- Amarillo, TX
National Provider Identifier
1811059280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2792TG
- Practice address
- 7701 W Interstate 40 Ste 102
Amarillo, TX 79121-0102 - Phone
- (806) 352-4438
- Fax
- (806) 352-5172
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2792TG | TX | Primary |
Addresses
Primary practice location
7701 W Interstate 40 Ste 102
Amarillo, TX 79121-0102
Mailing address
8801 Tarter Ave Apt 1015
Amarillo, TX 79119-6562
Phone (806) 352-4438
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070627000533 | TX | Practitioner - Optometry | 5496854788 | Practice locations: Fort Worth, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2792TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811059280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8801 TARTER AVE APT 1015",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791196562",
"telephone_number": "806-352-4438",
"fax_number": "806-352-5172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 W INTERSTATE 40 STE 102",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791210102",
"telephone_number": "806-352-4438",
"fax_number": "806-352-5172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTICK",
"first_name": "BRUCE",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "2792TG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.