Peter Joseph Zanella Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6868T Issued in TX

Practice address

2111 Kirkwood Blvd Ste 100
Southlake, TX 76092-1461

Phone

(817) 416-2010

Fax

(817) 416-2013

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

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.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment NPD
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)
• Rollenhagen Eye Care

  • Optometrist
  • Topeka, KS
  • NPI 1265517288
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1962464446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 KIRKWOOD BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921461",
            "telephone_number": "817-416-2010",
            "fax_number": "817-416-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 KIRKWOOD BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921461",
            "telephone_number": "817-416-2010",
            "fax_number": "817-416-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANELLA",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6868T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Your Therapy Source
• Michelle Yung
• Taylor Brianna Zalesky, OTR
• Zanella Optometry, PLLC
• Deborah Zanella, O.D.
• Viktoria Zatkalik, NP-C
• Zenvion Medical LLC
• Richard Zhang, MD
• Rebecca Christine Ziegler, LPC-A
• Summer N Zilisch

• 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 Jun 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.