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VISION SOURCE TROPHY CLUB
NPI 1689041634
Optometrist in Roanoke, TX

Active since August 25, 2015
856 E HIGHWAY 114 STE 100, ROANOKE, TX 76262(682) 237-2103 Get Directions Write a Review

NPPES record last updated: December 1, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 1, 2020, Oct 14, 2020 (2 updates tracked since 2020).

About Vision Source Trophy Club NPPES

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

VISION SOURCE TROPHY CLUB (NPI 1689041634) is a healthcare organization registered as an optometrist in Roanoke, Texas and active in the NPI registry since August 2015. The organization lists Kelvin Lam, President, as its authorized official.

NPPES Registry Identity

NPI1689041634
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameROANOKE VISION ASSOCIATES
Location Address856 E HIGHWAY 114 STE 100Roanoke, TX 76262-6790
Mailing Address301 Trophy Lake Dr, Ste 128Trophy Club, TX 76262-5238 · (682) 237-2103 · Fax (682) 803-0559
Phone(682) 237-2103
Organization SubpartNo
Authorized OfficialKelvin LamPresident · (469) 464-5949
Enumeration DateAugust 25, 2015
Last NPPES UpdateDecember 1, 20202 updates tracked since enumeration
NPPES CertifiedDecember 1, 2020
✔ NPI 1689041634 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 · 8216
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.
856 E HIGHWAY 114 STE 100, Roanoke, TX 76262
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Other Names 1

Doing Business AsVision Source Trophy Club

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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)

Vision Source Trophy Club 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 Vision Source Trophy Club, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kelvin Lam, O.D.
Optometry
NPI 1265871222
856 E HIGHWAY 114 STE 100
Roanoke, TX 76262
(682) 237-2103
✔ PECOS✔ Accepts MedicareSame address

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 Roanoke Vision Associates's NPI number?

The NPI number for Roanoke Vision Associates is 1689041634. It was assigned to this organization in the NPPES registry on August 25, 2015. The provider is doing business as Vision Source Trophy Club.

Where is Roanoke Vision Associates located?

Roanoke Vision Associates is located at 856 E Highway 114 Ste 100, Roanoke, TX 76262. The listed phone number is (682) 237-2103.

What is Roanoke Vision Associates's specialty?

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

Is Roanoke Vision Associates enrolled in Medicare?

Yes. Roanoke Vision Associates is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Roanoke Vision Associates?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Roanoke Vision Associates. 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.

What insurance does Roanoke Vision Associates 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 1 other insurer list Roanoke Vision Associates 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 Roanoke Vision Associates was last updated on December 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.