John D Boldan Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5488T Issued in TX

Practice address

1606 S Jefferson Ave
Mt Pleasant, TX 75455-5614

Phone

(903) 572-4000

Fax

(903) 575-0769

NPI assigned

Sep 16, 2008

Last updated

Jun 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Illinois College of Optometry at Chicago, 1997

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)

Procedures performed for Medicare patients

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
  • McKinney, TX
  • NPI 1245876309
  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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1922257864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 S BROADWAY ST",
            "address_2": "STE 2020",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754824902",
            "telephone_number": "903-438-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 S JEFFERSON AVE",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754555614",
            "telephone_number": "903-572-4000",
            "fax_number": "903-575-0769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 S Broadway St",
            "address_2": "ste 2020",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754824902",
            "country_code": "US",
            "telephone_number": "903-438-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDAN",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5488T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tricia Denise Blalock, PT, DPT
• Margaret Renee Blare, R.PH.
• Kelley Diane Blevins, LPTA
• Lynda Elizabeth Bockmon, ANP-BC, ACNP-BC
• Tammy Lynn Boggs, LPN
• Robyn Ann Boles, LCSW
• James Daniel Bove III, DO
• Jimmy Boyd, MD
• J. Colton Bradshaw, M.D.11/11/1952
• Michael K. Brandon II, APRN-CNP

• Optometrist in Mount Pleasant, TX
• Providers in Mount Pleasant, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.