Manoj Abraham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8563T Issued in TX

Practice address

1251 E Southlake Blvd
Suite 331
Southlake, TX 76092-6478

Phone

(817) 310-0289

NPI assigned

Jul 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

2020 EyedrGroup PAC ID 9537457189, 11 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 and National Provider Directory roles.

• 2020 Eyedr

  • Optometrist
  • Southlake, TX
  • NPI 1942754700
  Medicare reassignment Care Compare group NPD Authorized official
• Healthsync Vision Care

  • Optometrist
  • Katy, TX
  • NPI 1770514275
  Medicare reassignment
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)
• Visionworks, Inc

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD (past)
• Visionworks, Inc.

  • Optometrist
  • Niles, IL
  • NPI 1831115906
  NPD (past)

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1952500159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 STONE DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750101147",
            "telephone_number": "630-452-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 E SOUTHLAKE BLVD",
            "address_2": "SUITE 331",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926478",
            "telephone_number": "817-310-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "MANOJ",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009950",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8563T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Able Mobility and Medical Supply
• Michel Fares Abou-Obeid, D.M.D
• Aboudib Advanced Imaging Inc
• Aboudib Advanced Pain Center
• Jesstin Abraham, PT, DPT
• Melissa Breanne Abraham, DPT
• Lauren Abramson, MSN, APRN, PMHNP-BC
• Academy Foot & Ankle Specialists, P.a.
• Active Life Foot and Ankle of Texas
• Theresa J Adame-Brooks, PT

• Optometrist in Southlake, TX
• Providers in Southlake, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.