Individual provider Active NPI

Faresh S Mehta, O.D.

  • Optometrist
  • Liberty, TX
National Provider Identifier
1285680033
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5983TG Issued in TX
Practice address
2121 Hwy 146 Bypass
Liberty, TX 77575
Phone
(936) 336-6510
NPI assigned
May 25, 2006
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5983TG TX Primary

Addresses

Primary practice location

2121 Hwy 146 Bypass
Liberty, TX 77575

Mailing address

2121 Hwy 146 Bypass
Liberty, TX 77575
Phone (936) 336-6510

Other identifiers 3

IdentifierTypeStateIssuer
019093601MedicaidTX
019093603MedicaidTX
G000094P2MedicaidTX

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
I20040428000669 TX Practitioner - Optometry 0840287280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2121 Hwy 146 Byp
Liberty, TX 77575-6000
Phone (936) 336-6510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5983TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Faresh Mehta, O.D., P.a. CurrentSince Jun 10, 2003 Accepting new patients
Sharp Visions Inc Optometrist PastSince Nov 28, 2016 Accepting new patients

Locations

4145 Dowlen Rd
Beaumont, TX 77706
Phone (409) 347-2667

831 Highway 59 S
Cleveland, TX 77327
Phone (281) 432-7200

831 Highway 59 S
Ste A
Cleveland, TX 77327
Phone (281) 432-7200

5655 E Sam Houston Pkwy N
Houston, TX 77015
Phone (713) 450-3681

2121 Highway 146 Byp
Liberty, TX 77575
Phone (936) 336-2257

2801 N Main St
Liberty, TX 77575
Phone (409) 347-2667

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, 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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1285680033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HWY 146 BYPASS",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "77575",
            "telephone_number": "936-336-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HWY 146 BYPASS",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "77575",
            "telephone_number": "936-336-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "FARESH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5983TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019093601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019093603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G000094P2",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, TX

Sources for this page

Verify at the official NPI Registry.