Individual provider Active NPI

Jayson Kalathil Tomy, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1124542220
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9028TG Issued in TX
Practice address
6400 Fannin St Ste 1800
Houston, TX 77030-1526
Phone
(713) 486-9400
Fax
(713) 486-9592
NPI assigned
Jul 31, 2017
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9028TG TX Primary

Addresses

Primary practice location

6400 Fannin St Ste 1800
Houston, TX 77030-1526

Mailing address

6400 Fannin St Ste 1800
Houston, TX 77030-1526

Other identifiers 1

IdentifierTypeStateIssuer
395725001MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170828000731 TX Practitioner - Optometry 5698047520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 2961732193, 206 clinicians

Practice addresses (Care Compare)

6400 Fannin St
Suite 1800
Houston, TX 77030-1526
Phone (713) 486-9400

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
68.75
Promoting interoperability
100
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9028TXMDChiropractor
9028TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Mar 1, 2022 Accepting new patients

Locations

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

6400 Fannin St
Ste 1800
Houston, TX 77030
Phone (713) 486-9400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1124542220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 1800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 1800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301526",
            "telephone_number": "713-486-9400",
            "fax_number": "713-486-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMY",
        "first_name": "JAYSON",
        "middle_name": "KALATHIL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9028TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395725001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.