Individual provider Active NPI

Cristian Radaneata, OD

  • Optometrist
  • Kingsville, TX
National Provider Identifier
1992702864
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5189TG Issued in TX
Practice address
1016 S 14TH St
Kingsville, TX 78363-6422
Phone
(361) 592-4744
NPI assigned
Jul 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 5189TG TX
Pediatric Optometrist 152WP0200X 5189TG TX
Corneal and Contact Management Optometrist 152WC0802X 5189TG TX
Optometrist 152W00000X 5189TG TX Primary

Addresses

Primary practice location

1016 S 14TH St
Kingsville, TX 78363-6422

Mailing address

1016 S 14TH St
Kingsville, TX 78363-6422
Phone (361) 592-4744

Other practice location 1

5718 McArdle Rd Ste 104
Corpus Christi, TX 78412-3488
Phone (361) 991-0926

Other identifiers 2

IdentifierTypeStateIssuer
092993701MedicaidTX
P01042734OtherMEDICARE RAILROAD

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
I20110217000215 TX Practitioner - Optometry 0840471314 Receives reassigned benefits from 1 practitioner
Practice locations: Kingsville, TX; Corpus Christi, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2730 S Brahma Blvd
Suite 114B
Kingsville, TX 78363-7138
Phone (361) 592-4744

5718 McArdle Rd
Suite 104
Corpus Christi, TX 78412-3488
Phone (361) 991-0926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5189TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Arnoldo R. Villarreal, M. D., P.a. Past Accepting new patients
Berkeley Eye Institute, PLLC Optometrist Past Accepting new patients
Jacob J Moore MD PA Optometrist Past Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1992702864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 S 14TH ST",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783636422",
            "telephone_number": "361-592-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 S 14TH ST",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783636422",
            "telephone_number": "361-592-4744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5718 McArdle Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784123488",
            "country_code": "US",
            "telephone_number": "361-991-0926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADANEATA",
        "first_name": "CRISTIAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TX",
            "license": "5189TG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "5189TG",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "5189TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5189TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092993701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01042734",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsville, TX

Sources for this page

Verify at the official NPI Registry.