Active NPI
Jon P McCreary, DPM
- Foot & Ankle Surgery Podiatrist
- Fort Worth, TX
National Provider Identifier
1225030802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 1644
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 51 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218 | AR | MD | Foot & Ankle Surgery Podiatrist |
| 1644 | TX | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Indiana Podiatry, PC | Past | Accepting new patients | |
| W Douglas Boyd DPM PC | Past | 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.
-
- Foot & Ankle Surgery Podiatrist
- Fort Worth, TX
- NPI 1881182129
-
- Clinic/Center
- Fort Worth, TX
- NPI 1124263249
-
- Podiatric Clinic/Center
- Carmel, IN
- NPI 1356925382
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Fort Worth, TX
- NPI 1568883775
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1871599183
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.