Individual provider Active NPI

Alan Roy Tilson, O.D.

  • Optometrist
  • Irving, TX
National Provider Identifier
1144379751
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3102T Issued in TX
Practice address
4070 N Belt Line Rd Ste 168
Irving, TX 75038-5010
Phone
(972) 258-2020
Fax
(972) 258-2030
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3102T TX Primary

Addresses

Primary practice location

4070 N Belt Line Rd Ste 168
Irving, TX 75038-5010

Mailing address

4070 N Belt Line Rd Ste 168
Irving, TX 75038-5010
Phone (972) 258-2020

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
I20140717000840 TX Practitioner - Optometry 6406070077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewisville Eye Care PLLCGroup PAC ID 9537585815, 3 clinicians

Practice addresses (Care Compare)

190 E Round Grove Rd
Lewisville, TX 75067-8301
Phone (469) 549-0987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3102TXMDBehavioral Analyst
3102TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lewisville Eye Care, PLLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients

Locations

190 E Round Grove Rd
Lewisville, TX 75067
Phone (469) 549-0987

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144379751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 N BELT LINE RD STE 168",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750385010",
            "telephone_number": "972-258-2020",
            "fax_number": "972-258-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 N BELT LINE RD STE 168",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750385010",
            "telephone_number": "972-258-2020",
            "fax_number": "972-258-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILSON",
        "first_name": "ALAN",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3102T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.