Individual provider Active NPI

Marcia Mae Moore, OD

  • Optometrist
  • Bellaire, TX
National Provider Identifier
1821253816
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7219TG Issued in TX
Practice address
5001 Bissonnet St
Suite 107
Bellaire, TX 77401-4025
Phone
(713) 664-8087
Fax
(713) 664-8078
NPI assigned
Jul 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7219TG TX Primary

Addresses

Primary practice location

5001 Bissonnet St
Suite 107
Bellaire, TX 77401-4025

Mailing address

5001 Bissonnet St
Suite 107
Bellaire, TX 77401-4025
Phone (713) 664-8087

Other identifiers 1

IdentifierTypeStateIssuer
7219TGOtherTXTEXAS OPTOMETRY LICENSE

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
I20090513000173 TX Practitioner - Optometry 9032268594 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
Neurosensory Center of Bellaire PAGroup PAC ID 4385785088, 6 clinicians

Practice addresses (Care Compare)

5001 Bissonnet St
Suite 107
Bellaire, TX 77401-4015
Phone (713) 664-8087

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7219TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosensory Center of Bellaire PA Optometrist CurrentSince Oct 26, 2009 Accepting new patients
Bellaire Family Eye Care PA Optometrist Past Accepting new patients

Locations

5001 Bissonnet St
Ste 107
Bellaire, TX 77401
Phone (713) 664-8087

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": "1216425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1821253816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 BISSONNET ST",
            "address_2": "SUITE 107",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014025",
            "telephone_number": "713-664-8087",
            "fax_number": "713-664-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 BISSONNET ST",
            "address_2": "SUITE 107",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014025",
            "telephone_number": "713-664-8087",
            "fax_number": "713-664-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARCIA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-19",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7219TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY LICENSE",
            "identifier": "7219TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

Verify at the official NPI Registry.