PEDIATRIC OPHTHALMOLOGY PA
NPI 1619195047
Ophthalmology in Grapevine, TX

Q: What is Pediatric Ophthalmology PA's NPI number?

The NPI number for Pediatric Ophthalmology PA is 1619195047. It was assigned to this organization in the NPPES registry on April 23, 2007.

Q: What is Pediatric Ophthalmology PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since April 23, 2007

1631 LANCASTER DR, # 200, GRAPEVINE, TX 76051(817) 329-5433(817) 329-5532 Get Directions Write a Review

NPPES record last updated: September 8, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Pediatric Ophthalmology Pa NPPES

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

PEDIATRIC OPHTHALMOLOGY PA (NPI 1619195047) is a healthcare organization registered as an ophthalmology in Grapevine, Texas and active in the NPI registry since April 2007. The organization lists David R Stager, President, as its authorized official.

NPPES Registry Identity

NPI1619195047

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NamePEDIATRIC OPHTHALMOLOGY PA

Location Address1631 LANCASTER DR, # 200Grapevine, TX 76051-3585

Mailing Address8222 Douglas Ave, Ste 400Dallas, TX 75225-5923 · (214) 369-6434 · Fax (214) 696-6273

Phone(817) 329-5433

Fax(817) 329-5532

Organization SubpartNo

Authorized OfficialDavid R StagerPresident · (214) 369-6434

Enumeration DateApril 23, 2007

Last NPPES UpdateSeptember 8, 2010

✔ NPI 1619195047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1631 LANCASTER DR, Grapevine, TX 76051

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Other Identifiers 2

Medicaid130345509TX

Medicare PIN00486RTX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pediatric Ophthalmology Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pediatric Ophthalmology PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Cynthia Beauchamp, MD

Ophthalmology

NPI 1639399504

8222 DOUGLAS AVE STE 400
Dallas, TX 75225

(214) 369-6434

✔ PECOS✔ Accepts Medicare17 mi

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 Pediatric Ophthalmology PA's NPI number?

The NPI number for Pediatric Ophthalmology PA is 1619195047. It was assigned to this organization in the NPPES registry on April 23, 2007.

Where is Pediatric Ophthalmology PA located?

Pediatric Ophthalmology PA is located at 1631 Lancaster Dr # 200, Grapevine, TX 76051. The listed phone number is (817) 329-5433.

What is Pediatric Ophthalmology PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Pediatric Ophthalmology PA enrolled in Medicare?

Yes. Pediatric Ophthalmology PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pediatric Ophthalmology PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to Pediatric Ophthalmology PA. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pediatric Ophthalmology PA was last updated on September 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.