Individual provider Active NPI

Amy D Kirkpatrick-Hartman, O.D.

  • Optometrist
  • Victoria, TX
National Provider Identifier
1881642916
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5410TG Issued in TX
Practice address
3804 John Stockbauer Dr
Suite a-2
Victoria, TX 77904-2448
Phone
(361) 570-2010
Fax
(361) 570-2012
NPI assigned
May 4, 2006
Last updated
Jan 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 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 5410TG TX Primary

Addresses

Primary practice location

3804 John Stockbauer Dr
Suite a-2
Victoria, TX 77904-2448

Mailing address

3804 John Stockbauer Dr
Suite a-2
Victoria, TX 77904-2448
Phone (361) 570-2010

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
I20090422000639 TX Practitioner - OptometryPractitioner - Ophthalmology 2860540259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Faye N. Tupa, O.D., P.C.Group PAC ID 7719058833, 2 clinicians

Practice addresses (Care Compare)

1308 N Main St
Victoria, TX 77901-5911
Phone (361) 582-4966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5410TXMDBehavioral Analyst
5410TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Faye N. Tupa, O.D., P.C. Optometrist CurrentSince Sep 12, 2022 Accepting new patients
Victoria Family Eyecare Optometrist Past Accepting new patients
Caia D. Homerstad OD PLLC Optometrist PastSince Sep 12, 2022 Accepting new patients
Victoria Vision Center LLC PastSince May 1, 2017 Accepting new patients
Barry Wineinger OD Optometrist PastSince Jul 1, 2017 Accepting new patients

Locations

1308 N Main St
Victoria, TX 77901
Phone (361) 582-4966

3804 John Stockbauer Dr
Ste A
Victoria, TX 77904
Phone (361) 570-2010

3804 John Stockbauer Dr
Ste A2
Victoria, TX 77904
Phone (361) 570-2010

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1881642916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 JOHN STOCKBAUER DR",
            "address_2": "SUITE A-2",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042448",
            "telephone_number": "361-570-2010",
            "fax_number": "361-570-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 JOHN STOCKBAUER DR",
            "address_2": "SUITE A-2",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042448",
            "telephone_number": "361-570-2010",
            "fax_number": "361-570-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKPATRICK-HARTMAN",
        "first_name": "AMY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5410TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.