James N. Tisdale, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2309TG Issued in TX

Practice address

114 Professional Park Dr
Victoria, TX 77904-2351

Phone

(361) 578-8441

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. James N. Tisdale Professional name

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. James N. Tisdale, O.D., P.C.

  • Optometrist
  • Victoria, TX
  • NPI 1407027212
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1073622692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-578-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-578-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "JAMES",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2309TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "440-56-97",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE RAILROAD RETIREMENT BOARD'S MEDICARE CARRIER",
            "identifier": "410011742",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "82179Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "TISDALE",
            "middle_name": "N.",
            "prefix": "DR.",
            "credential": "OPTOMETRIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Courtney Thompson, PA-C
• Elizabeth Thompson
• Melissa Tieu, PHARMD
• Dennis Dean Tillotson, DC
• Anselm Jingwa Tintinu, MD
• W Dennis Tobin, MD
• Stephanie Todd, M.S., CCC-SLP
• Denise Mary Tomanek
• Leif Toombs, D.C.
• Abigail Torres, OTR

• Optometrist in Victoria, TX
• Providers in Victoria, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.