Active NPI
Jaime Rene Gonzalez, O.D.
- Optometrist
- Grand Prairie, TX
National Provider Identifier
1083724322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6968T
- Practice address
- 2634 S Carrier Pkwy
101
Grand Prairie, TX 75052-5070 - Phone
- (972) 641-0011
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6968T | TX | Primary |
Addresses
Primary practice location
2634 S Carrier Pkwy
101
Grand Prairie, TX 75052-5070
Mailing address
2634 S Carrier Pkwy Ste 101
Grand Prairie, TX 75052-5005
Phone (972) 641-0011
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071128000312 | TX | Practitioner - Optometry | 1658460738 | Practice locations: Plano, TX; Dallas, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3699 McKinney Ave
Suite 321
Dallas, TX 75204-4563
Phone (214) 219-4402
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6968T | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thai-an Nguyen OD PLLC | Optometrist | Past | Accepting new patients |
| 20/20 Icare and Iwear, PLLC | Optometrist | Past | Accepting new patients |
| 20-20 Sight, PA | Optometrist | Past | Accepting new patients |
| Legacy Eye Pieces PC | Optometrist | Past | Accepting new patients |
| West Village Eye Pieces PC | Optometrist | Past | Accepting new patients |
| Chris Darilek, OD, PLLC | Optometrist | Past | Accepting new patients |
| Dr. Michael K. Hammond, PA | Optometrist | Past | Accepting new patients |
Organizations & group practices 7
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.
-
- Optometrist
- Dallas, TX
- NPI 1568196343
-
- Optometrist
- Grand Prairie, TX
- NPI 1760416408
-
- Optometrist
- Grand Prairie, TX
- NPI 1932629987
-
- Optometrist
- Dallas, TX
- NPI 1407409626
-
- Optometrist
- Grand Prairie, TX
- NPI 1346436193
-
- Optometrist
- Plano, TX
- NPI 1912629205
-
- Optometrist
- Grand Prairie, TX
- NPI 1851717243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1083724322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2634 S CARRIER PKWY STE 101",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750525005",
"telephone_number": "972-641-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2634 S CARRIER PKWY",
"address_2": "101",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750525070",
"telephone_number": "972-641-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JAIME",
"middle_name": "RENE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6968T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.