Individual provider Active NPI

Kaitlin Siojo

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1811568587
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10280 Issued in TX
Practice address
15900 La Cantera Pkwy
San Antonio, TX 78256-2587
Phone
(210) 641-2405
NPI assigned
Jul 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10280 TX Primary

Addresses

Primary practice location

15900 La Cantera Pkwy
San Antonio, TX 78256-2587

Mailing address

16735 La Cantera Pkwy Apt 10103
San Antonio, TX 78256-1789
Phone (210) 262-2395

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
I20210817002210 TX Practitioner - Optometry 9739584541 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10280TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
RCP Eyecare, PC Optometrist CurrentSince Jul 5, 2021 Accepting new patients
Bright Eyecare PLLC Optometrist CurrentSince Jan 25, 2025 Accepting new patients

Locations

3818 S New Braunfels Ave
San Antonio, TX 78223
Phone (210) 532-5261

18030 San Pedro Ave
Ste 250B
San Antonio, TX 78232
Phone (210) 545-3183

15900 La Cantera Pkwy
Ste 9915
San Antonio, TX 78256
Phone (210) 641-2405

Organizations & group practices 2

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": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1811568587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16735 LA CANTERA PKWY APT 10103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782561789",
            "telephone_number": "210-262-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 LA CANTERA PKWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782562587",
            "telephone_number": "210-641-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIOJO",
        "first_name": "KAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-07-05",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.