Individual provider Active NPI

Ansu Mariam Bensen, OD

  • Optometrist
  • Greenville, TX
National Provider Identifier
1992475768
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10495 Issued in TX
Practice address
3802 Joe Ramsey Blvd E
Greenville, TX 75401-7711
Phone
(903) 454-0471
Fax
(903) 450-4332
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003815 PA
Optometrist 152W00000X 10495 TX Primary

Addresses

Primary practice location

3802 Joe Ramsey Blvd E
Greenville, TX 75401-7711

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20220412001594 TX Practitioner - Optometry 3173919552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2021
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)

3802 Joe Ramsey Blvd E
Greenville, TX 75401-7711
Phone (903) 454-0471

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003815PAMDOptometrist
10495TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Apr 18, 2022 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Apr 18, 2022 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

6446 Lyndon B Johnson Fwy
Dallas, TX 75240
Phone (972) 960-2020

3802 Joe Ramsey Blvd E
Greenville, TX 75401
Phone (903) 454-0471

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: abensen025480@myeyedr.emadirect.md

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1992475768",
    "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": "3802 JOE RAMSEY BLVD E",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017711",
            "telephone_number": "903-454-0471",
            "fax_number": "903-450-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSEN",
        "first_name": "ANSU",
        "middle_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003815",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

Verify at the official NPI Registry.