Individual provider Active NPI

John Thomas Gill, O.D.

  • Optometrist
  • Corpus Christi, TX
National Provider Identifier
1912015454
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5245TG Issued in TX
Practice address
5425 S Padre Island Dr
Corpus Christi, TX 78411-5301
Phone
(361) 993-7778
NPI assigned
Aug 25, 2006
Last updated
Nov 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5245TG TX Primary

Addresses

Primary practice location

5425 S Padre Island Dr
Corpus Christi, TX 78411-5301

Mailing address

5425 S Padre Island Dr
Corpus Christi, TX 78411-5301
Phone (361) 993-7778

Other identifiers 1

IdentifierTypeStateIssuer
041835201MedicaidTX

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
I20080505000163 TX Practitioner - Optometry 4183703002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walz Vision PAGroup PAC ID 8729171855, 4 clinicians

Practice addresses (Care Compare)

5425 S Padre Island Dr
Corpus Christi, TX 78411-5301

5425 S Padre Island Dr
Corpus Christi, TX 78411-5342
Phone (361) 993-7778

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5245TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Walz Vision PA Optometrist CurrentSince Apr 4, 2007 Accepting new patients

Locations

5425 Spid Dr
Corpus Christi, TX 78411
Phone (361) 980-8979

5425 Spid Dr
Ste 119B
Corpus Christi, TX 78411
Phone (361) 993-7778

Organizations & group practices 1

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1912015454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 S PADRE ISLAND DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784115301",
            "telephone_number": "361-993-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 S PADRE ISLAND DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784115301",
            "telephone_number": "361-993-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5245TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041835201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.