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SUSAN LY JOHNSON O.D.
NPI 1235683889
Optometrist in Boerne, TX

Active since August 12, 2016PECOS EnrolledAccepts Medicare Assignment
124 E BANDERA RD STE 403, BOERNE, TX 78006(830) 331-8745(830) 331-8749 Get Directions Write a Review

NPPES record last updated: February 28, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 28, 2018, Aug 12, 2016 (2 updates tracked since 2016).

About Susan Ly Johnson O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN LY JOHNSON O.D. (NPI 1235683889) is an individual optometrist in Boerne, Texas, licensed in Texas (8940-TG) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1235683889
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameSUSAN LY JOHNSONCredential: O.D.
Location Address124 E BANDERA RD STE 403Boerne, TX 78006-2849
Mailing Address124 E Bandera Rd Ste 403Boerne, TX 78006-2849 · (830) 331-8745 · Fax (830) 331-8749
Phone(830) 331-8745
Fax(830) 331-8749
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 12, 2016
Last NPPES UpdateFebruary 28, 20182 updates tracked since enumeration
✔ NPI 1235683889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in TX · 8940-TG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
124 E BANDERA RD STE 403, Boerne, TX 78006
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Other Identifiers 1

Medicaid376410201TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Susan Ly Johnson O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769764075
PECOS Enrollment IDI20170123000246
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Susan Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Boerne Vision Center PA
0.1 mi
Optometrist
124 E BANDERA RD, SUITE 403
Boerne, TX 78006
  • Reassigned Medicare billing, Texas enrollment
  • 3 clinicians in this Medicare group
NPI 1609149731 (830) 331-8745
University Of The Incarnate Word
20 mi
Optometrist
9725 DATAPOINT DR
San Antonio, TX 78229
  • Reassigned Medicare billing, Texas enrollment
  • 76 clinicians in this Medicare group
NPI 1003129784 (210) 883-1194

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
74 services71 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
63 services48 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
45 services41 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
34 services32 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
30 services29 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78006 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Johnson's NPI number?

The NPI number for Susan Johnson is 1235683889. It was assigned to this individual provider in the NPPES registry on August 12, 2016.

Where is Susan Johnson located?

Susan Johnson practices at 124 E Bandera Rd Ste 403, Boerne, TX 78006. The listed phone number is (830) 331-8745.

What is Susan Johnson's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Susan Johnson enrolled in Medicare?

Yes. Susan Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Susan Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Johnson reassigns Medicare benefits to 2 organizations: Boerne Vision Center PA (Boerne, TX) and University Of The Incarnate Word (San Antonio, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susan Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Susan Johnson accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 16 other insurers list Susan Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Susan Johnson was last updated on February 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.