Individual provider Active NPI

Jon P McCreary, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fort Worth, TX
National Provider Identifier
1225030802
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1644 Issued in TX
Practice address
3221 Hulen St Ste a
Fort Worth, TX 76107-6186
Phone
(817) 731-4279
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 218 AR
Foot & Ankle Surgery Podiatrist 213ES0103X 1644 TX Primary

Addresses

Primary practice location

3221 Hulen St Ste a
Fort Worth, TX 76107-6186

Mailing address

PO Box 92096
Southlake, TX 76092-0101
Phone (817) 731-4279

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
I20031204000494 TX Practitioner - Podiatry 0446155295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3221 Hulen St
Suite a
Fort Worth, TX 76107-6186
Phone (817) 731-4279

Hospital & facility affiliations

  • Baylor Scott and White Surgical Hospital Fortworth Hospital, Fort Worth, TX, CCN 450880

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
218ARMDFoot & Ankle Surgery Podiatrist
1644TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Indiana Podiatry, PC Past Accepting new patients
W Douglas Boyd DPM PC PastSince Oct 1, 2018 Accepting new patients
Major Hospital Past Accepting new patients

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1225030802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92096",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920101",
            "telephone_number": "817-731-4279",
            "fax_number": "817-731-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 HULEN ST STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076186",
            "telephone_number": "817-731-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREARY",
        "first_name": "JON",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "218",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.