Active NPI
Bridget Joy Leesang, O.D.
- Optometrist
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5136TG
- Practice address
- 22906 US Highway 281 N
San Antonio, TX 78258-7632 - Phone
- (210) 495-7483
- Fax
- (210) 497-1206
- NPI assigned
- Jan 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 5136TG | TX | Primary |
Addresses
Primary practice location
22906 US Highway 281 N
San Antonio, TX 78258-7632
Mailing address
1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019416901 | Medicaid | TX |
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
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
255 E Basse Rd
Suite 330
San Antonio, TX 78209-8343
Phone (210) 308-8565
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5136TG | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Med Southwest, PLLC | Optometrist | Current | Accepting new patients |
| Med Southwest, PLLC | Optometrist | Current | Accepting new patients |
| Med Southwest, PLLC | Optometrist | Current | Accepting new patients |
| Bridget Leesang OD | Optometrist | Past | Accepting new patients |
| Silver Spring Optometry, LLC | Optometrist | Past | Accepting new patients |
Locations
4437 De Zavala Rd
#A
San Antonio, TX 78249
Phone (210) 492-7483
22906 US Highway 281 N
Ste 101
San Antonio, TX 78258
Phone (210) 492-7483
255 E Basse Rd
Ste 330
San Antonio, TX 78209
Phone (210) 308-8565
2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
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 and National Provider Directory roles.
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- Optometrist
- San Antonio, TX
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- Optometrist
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- NPI 1679440762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1902886898",
"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": "22906 US HIGHWAY 281 N",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782587632",
"telephone_number": "210-495-7483",
"fax_number": "210-497-1206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEESANG",
"first_name": "BRIDGET",
"middle_name": "JOY",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5136TG",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019416901",
"state": "TX"
}
],
"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 Oct 20, 2021; 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.