Individual provider Active NPI

Dennis E Mathews, OD

  • Optometrist
  • Memphis, TN
National Provider Identifier
1184617367
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1000 Issued in TN
Practice address
825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone
(901) 685-2200
Fax
(901) 820-2342
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 675 MS
Optometrist 152W00000X 1000 TN Primary

Addresses

Primary practice location

825 Ridge Lake Blvd
Memphis, TN 38120-9411

Mailing address

825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone (901) 685-2200

Other identifiers 9

IdentifierTypeStateIssuer
675OtherMSOD LICENSE
410022830OtherTNRR MEDICARE
111234722MedicaidAR
3124319OtherTNBCBSTN
1000OtherTNOD LICENSE
P01120062OtherMSRR MEDICARE
00087009MedicaidMS
3595763MedicaidTN
316826809MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080514000486 TN Practitioner - Optometry 0042317323 Reassigns benefits to 1 organization
I20120224000131 MS Practitioner - Optometry 0042317323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VRF Eye Specialty Group, PLCGroup PAC ID 2264328723, 16 clinicians

Practice addresses (Care Compare)

7600 Airways Blvd
Suite F
Southaven, MS 38671-5138
Phone (901) 685-2200

825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone (901) 685-2200

Merit-based Incentive Payment System (MIPS)

Final score
84.7 of 100Reported as group
Quality
86.03
Improvement activities
40
Cost
74.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
675MSMDOptometrist
1000TNMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
VRF Eye Specialty Group, PLC Optometrist CurrentSince Apr 30, 2008 Accepting new patients
VRF Eye Specialty Group, PLC Optometrist CurrentSince Apr 30, 2008 Accepting new patients

Locations

412 Central Ave
Coldwater, MS 38618
Phone (662) 622-5173

6947 Crumpler Blvd
Olive Branch, MS 38654
Phone (662) 893-3300

7600 Airways Blvd
Ste F
Southaven, MS 38671
Phone (662) 349-5901

391 Southcrest Cir
Ste 108
Southaven, MS 38671
Phone (662) 349-0910

7600 Airways Blvd
Ste C
Southaven, MS 38671
Phone (901) 683-4600

1458 W Poplar Ave
Ste 101
Collierville, TN 38017

825 Ridge Lake Blvd
Memphis, TN 38120
Phone (901) 685-6150

5146 Stage Rd
Ste 101
Memphis, TN 38134
Phone (901) 377-3475

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

825 Ridge Lake Blvd
Ste 200
Memphis, TN 38120

Interoperability endpoints

  • Direct secure messaging: drmathews@esg.emadirect.md

Organizations & group practices 2

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184617367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209411",
            "telephone_number": "901-685-2200",
            "fax_number": "901-820-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209411",
            "telephone_number": "901-685-2200",
            "fax_number": "901-820-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "DENNIS",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "675",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD LICENSE",
            "identifier": "675",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410022830",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111234722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN",
            "identifier": "3124319",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD LICENSE",
            "identifier": "1000",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01120062",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087009",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3595763",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316826809",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.