Active NPI
Jeffrey M. Ekery, O.D.
- Optometrist
- El Paso, TX
National Provider Identifier
1245223775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2188TG
- Practice address
- 4724 Montana Ave
El Paso, TX 79903-4811 - Phone
- (915) 566-8693
- Fax
- (915) 566-9229
- NPI assigned
- Aug 30, 2005
- Reactivated
- Apr 12, 2006
- Last updated
- Apr 24, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2188TG | TX | Primary |
Addresses
Primary practice location
4724 Montana Ave
El Paso, TX 79903-4811
Mailing address
4724 Montana Ave
El Paso, TX 79903-4811
Phone (915) 566-8693
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 093043002 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2188TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1245223775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4724 MONTANA AVE",
"city": "EL PASO",
"state": "TX",
"postal_code": "799034811",
"telephone_number": "915-566-8693",
"fax_number": "915-566-9229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4724 MONTANA AVE",
"city": "EL PASO",
"state": "TX",
"postal_code": "799034811",
"telephone_number": "915-566-8693",
"fax_number": "915-566-9229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EKERY",
"first_name": "JEFFREY",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2012-04-24",
"deactivation_date": "2006-03-24",
"reactivation_date": "2006-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "2188TG",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "093043002",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
- Lauren Nicole Eisenberg, D,O.
- Laaibah Ejaz, MBBS
- Shannon Ejiofor, DO
- Beatrice Chisara Ekechukwu
- Fred N. Ekery, M.D.
- Fabiola S Ekleberry, M.ED, LPC-S, NCC
- Jimmie Lynn Ekola, LMSW
- Anthony Abang Ekwale, PHARM.D.
- Saif El Naser H Mahmoud El Nawaa, MD
- El Palacio Adult Day Care LLC (El Palacio Adult Day Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.