Active NPI
Kent Charles Jensen, O.D.
- Optometrist
- San Antonio, TX
National Provider Identifier
1841360633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3951TG
- Practice address
- 11703 Huebner Rd
Suite 109
San Antonio, TX 78230-1201 - Phone
- (210) 764-7575
- Fax
- (210) 764-7576
- NPI assigned
- Nov 8, 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 | 3951TG | TX | Primary |
Addresses
Primary practice location
11703 Huebner Rd
Suite 109
San Antonio, TX 78230-1201
Mailing address
11703 Huebner Rd
Suite 109
San Antonio, TX 78230-1201
Phone (210) 764-7575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 270049 | Other | MEDICARE PTAN |
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 |
|---|---|---|---|---|
| I20070305000377 | TX | Practitioner - Optometry | 1153424544 | Practice locations: San Antonio, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
11703 Huebner Rd
Suite 109
San Antonio, TX 78230-1211
Phone (210) 764-7575
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3951TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370476800000",
"number": "1841360633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11703 HUEBNER RD",
"address_2": "SUITE 109",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782301201",
"telephone_number": "210-764-7575",
"fax_number": "210-764-7576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11703 HUEBNER RD",
"address_2": "SUITE 109",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782301201",
"telephone_number": "210-764-7575",
"fax_number": "210-764-7576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "KENT",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2013-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "3951TG",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "270049",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.