LAKELINE VISION SOURCE
NPI 1265489777
Optometrist in Cedar Park, TX
About Lakeline Vision Source NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKELINE VISION SOURCE (NPI 1265489777) is a healthcare organization registered as an optometrist in Cedar Park, Texas and active in the NPI registry since May 2006. The organization lists Michelle L Wiggins, Credentialing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lakeline Vision Source is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Lakeline Vision Source, which bills Medicare for the services they deliver. Of these, 10 practice at this address. They are listed nearest first.
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Lakeline Vision, P.C.'s NPI number?
The NPI number for Lakeline Vision, P.C. is 1265489777. It was assigned to this organization in the NPPES registry on May 28, 2006. The provider is doing business as Lakeline Vision Source.
Where is Lakeline Vision, P.C. located?
Lakeline Vision, P.C. is located at 3419 El Salido Pkwy Ste 100, Cedar Park, TX 78613. The listed phone number is (512) 918-3937.
What is Lakeline Vision, P.C.'s specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Lakeline Vision, P.C. enrolled in Medicare?
Yes. Lakeline Vision, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lakeline Vision, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians, all in Optometry, reassign their Medicare billing to Lakeline Vision, P.C.. A 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 the clinician's services. Of these, 10 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lakeline Vision, P.C. accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee and 2 other insurers list Lakeline Vision, P.C. 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 Lakeline Vision, P.C. was last updated on October 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Lakeline Vision Source · NPI 1265489777
Optometrist organization in Cedar Park, Texas. Organization record, active in the CMS NPPES registry since May 28, 2006.
## Identity
- **NPI:** 1265489777 (Entity type: Organization)
- **Enumerated:** May 28, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Lakeline Vision, P.c.
- **Organization subpart:** No
- **Authorized official:** Michelle Wiggins, CREDENTIALING MANAGER
## Practice location
- **Address:** 3419 EL SALIDO PKWY STE 100, Cedar Park, TX 78613-5639
- **Phone:** (512) 918-3937 · **Fax:** (512) 918-2028
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 10 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 5, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1265489777) · Data from the CMS NPPES public registry.