Individual provider Active NPI

Kelly Li Zhu, OD

  • Optometrist
  • Austin, TX
National Provider Identifier
1821831165
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11185TG Issued in TX
Practice address
6929 Airport Blvd Ste 165
Austin, TX 78752-3616
Phone
(512) 580-9035
NPI assigned
Jun 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 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 11185TG TX Primary

Addresses

Primary practice location

6929 Airport Blvd Ste 165
Austin, TX 78752-3616

Mailing address

6929 Airport Blvd Ste 165
Austin, TX 78752-3616

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
I20241015001377 TX Practitioner - Optometry 3375075419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jandw Vision Associates, PLLCGroup PAC ID 1254680747, 3 clinicians

Practice addresses (Care Compare)

6929 Airport Blvd
Suite 165
Austin, TX 78752-3616
Phone (512) 580-9035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11185TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
J&W Vision Associates, PLLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Resolution Eyecare Tech Ridge, PLLC Optometrist CurrentSince Dec 1, 2024 Accepting new patients
Resolution Eyecare Round Rock, PLLC Optometrist PastSince Dec 1, 2024 Accepting new patients

Locations

12901 N Interstate 35
Ste 1305B
Austin, TX 78753
Phone (512) 886-0023

6929 Airport Blvd
Ste 165
Austin, TX 78752
Phone (512) 580-9035

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1821831165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6929 AIRPORT BLVD STE 165",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6929 AIRPORT BLVD STE 165",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523616",
            "telephone_number": "512-580-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHU",
        "first_name": "KELLY",
        "middle_name": "LI",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11185TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.