Amanda Bloomberg, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

8972TG Issued in TX

Practice address

850 William D Fitch Pkwy Ste 700
College Station, TX 77845-6464

Phone

(979) 690-0147

Fax

(844) 527-3857

NPI assigned

Jun 27, 2016

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment Care Compare group NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Longview, TX
  • NPI 1487290441
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Silver Spring Optometry, LLC

  dba My Eye Dr

  • Optometrist
  • Silver Spring, MD
  • NPI 1336204387
  NPD (past)

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1871944207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WILLIAM D FITCH PKWY STE 700",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456464",
            "telephone_number": "979-690-0147",
            "fax_number": "844-527-3857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 University Dr E Ste 140",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778023487",
            "country_code": "US",
            "telephone_number": "979-731-8446",
            "fax_number": "844-527-3856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOMBERG",
        "first_name": "AMANDA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8972TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Blazek
• Britney Bledsoe, LMSW
• Dean Blevins, MD
• Bethany Alysse Blewett
• Amy Kathryn Blok, CRNA
• Leslie Bloomer, CCC-SLP
• Paula Renae Blume, PT
• Garrett Blundell, D.D.S., M.D.
• Heidemarie W. Boas, NP
• Renny Boase

• Optometrist in College Station, TX
• Providers in College Station, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.

Verify at the official NPI Registry.