Individual provider Active NPI

Farah Hassam

  • Optometrist
  • Dallas, TX
National Provider Identifier
1184019549
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8625TG Issued in TX
Practice address
8055 Churchill Way
Dallas, TX 75251-2149
Phone
(469) 680-7561
NPI assigned
Apr 2, 2015
Last updated
Oct 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8625TG TX Primary

Addresses

Primary practice location

8055 Churchill Way
Dallas, TX 75251-2149

Mailing address

8055 Churchill Way
Dallas, TX 75251-2149

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
I20170515000407 TX Practitioner - Optometry 1850678160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Waterloo - School of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Farah Hassam LLCGroup PAC ID 7416234729, 3 clinicians

Practice addresses (Care Compare)

8055 Churchill Way
See Clear Eye Care
Dallas, TX 75251-2149
Phone (469) 680-7561

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8625TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Farah Hassam LLC Optometrist CurrentSince May 11, 2017 Accepting new patients

Locations

8055 Churchill Way
Dallas, TX 75251
Phone (469) 680-7546

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1184019549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 CHURCHILL WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8055 CHURCHILL WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512149",
            "telephone_number": "469-680-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAM",
        "first_name": "FARAH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8625TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.