Individual provider Active NPI

Andrea Vanessa Adeyemi, OD

  • Optometrist
  • Whitney, TX
National Provider Identifier
1811373012
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10673 Issued in TX
Practice address
1221 N Brazos St
Whitney, TX 76692-2052
Phone
(254) 694-3435
NPI assigned
Aug 11, 2015
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10673 TX Primary

Addresses

Primary practice location

1221 N Brazos St
Whitney, TX 76692-2052

Mailing address

5321 Copper MTN
Waco, TX 76708-6901
Phone (678) 361-5592

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
I20221107001187 TX Practitioner - Optometry 6204135551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitney Family Eyecare P.C.Group PAC ID 7618172461, 2 clinicians

Practice addresses (Care Compare)

1221 N Brazos St B
Whitney, TX 76692-2052
Phone (254) 694-3435

Merit-based Incentive Payment System (MIPS)

Final score
89.54 of 100Reported as group
Quality
79.08
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10673TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whitney Family Eyecare P.C. CurrentSince Oct 3, 2022 Accepting new patients
Hewitt Vision, PLLC Optometrist PastSince Aug 1, 2022 Accepting new patients
Temple Optometrists, P.C. Optometrist PastSince Aug 1, 2022 Accepting new patients

Locations

1221 N Brazos St
Whitney, TX 76692
Phone (254) 694-3435

1221 N Brazos St
#B
Whitney, TX 76692
Phone (254) 694-3435

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1811373012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 COPPER MTN",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767086901",
            "telephone_number": "678-361-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N BRAZOS ST",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922052",
            "telephone_number": "254-694-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYEMI",
        "first_name": "ANDREA",
        "middle_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitney, TX

Sources for this page

Verify at the official NPI Registry.