Individual provider Active NPI

Jon Mark Berry, M.D.

  • Ophthalmology Physician
  • Live Oak, TX
National Provider Identifier
1174637482
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
H9797 Issued in TX
Practice address
11601 Toepperwein Rd
Live Oak, TX 78233-3147
Phone
(210) 946-2020
Fax
(210) 590-3936
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

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
Ophthalmology Physician 207W00000X H9797 TX Primary

Addresses

Primary practice location

11601 Toepperwein Rd
Live Oak, TX 78233-3147

Mailing address

11601 Toepperwein Rd
Live Oak, TX 78233-3147
Phone (210) 946-2020

Other identifiers 1

IdentifierTypeStateIssuer
084865701MedicaidTX

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000772 TX Practitioner - Ophthalmology 2163480724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Southwestern Medical School at Dallas, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alamo City Eye Physicians PA 4 clinicians

Practice addresses (Care Compare)

11601 Toepperwein Rd
Live Oak, TX 78233-3403
Phone (210) 946-2020

Merit-based Incentive Payment System (MIPS)

Final score
89.74 of 100Reported as group
Quality
88.37
Improvement activities
40
Cost
81.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H9797TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alamo City Eye Physicians PA Ophthalmology CurrentSince Feb 11, 1992 Accepting new patients
Alamo City Eye Physicians PA CurrentSince Feb 11, 1992 Accepting new patients
Surgical Eye Center of San Antonio Current Accepting new patients
Alamo Cty Eye Physicians Past Accepting new patients

Locations

11601 Toepperwein Rd
Live Oak, TX 78233
Phone (210) 946-2020

19026 Stone Oak Pkwy
Ste 216
San Antonio, TX 78258
Phone (210) 946-2020

3327 Research Plz
Ste 306
San Antonio, TX 78235
Phone (210) 946-2020

Interoperability endpoints

  • Direct secure messaging: j.berry.p2@direct.saeye.nextgenshare.com

Organizations & group practices 4

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174637482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333147",
            "telephone_number": "210-946-2020",
            "fax_number": "210-590-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333147",
            "telephone_number": "210-946-2020",
            "fax_number": "210-590-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JON",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "H9797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084865701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.