Individual provider Active NPI

Jeremy Russell Cefalu, MD

  • Ophthalmology Physician
  • Tyler, TX
National Provider Identifier
1306289186
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
R2073 Issued in TX
Practice address
1327 Troup Hwy
Tyler, TX 75701
Phone
(903) 606-4733
NPI assigned
Apr 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X R2073 TX Primary

Addresses

Primary practice location

1327 Troup Hwy
Tyler, TX 75701

Mailing address

PO Box 846098
Dallas, TX 75284-6098

Other practice location 1

1327 Troup Hwy
Tyler, TX 75701
Phone (903) 606-4733

Other identifiers 3

IdentifierTypeStateIssuer
371443805MedicaidTX
693517OtherTXMEDICARE
8JX800OtherTXBCBS

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170530000331 TX Practitioner - Ophthalmology 4284930983 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in Shreveport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Texas Eye Care Associates PLLCGroup PAC ID 2567454085, 12 clinicians

Practice addresses (Care Compare)

2440 E 5TH St
Tyler, TX 75701-3525
Phone (903) 595-0500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2073TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Aug 15, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 15, 2018 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 7, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
East Texas Eye Care Associates PLLC CurrentSince Dec 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Ophthalmology CurrentSince Jul 7, 2017 Accepting new patients
East Texas Eye Care Associates PLLC Ophthalmology CurrentSince Dec 1, 2022 Accepting new patients

Locations

608 S Palestine St
Athens, TX 75751
Phone (903) 675-6440

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

800 8th Ave
Ste 306
Fort Worth, TX 76104
Phone (817) 336-1300

1440 S Main St
Lindale, TX 75771
Phone (903) 882-8990

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

1327 Troup Hwy
Tyler, TX 75701
Phone (903) 510-8764

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

2440 E 5th St
Tyler, TX 75701
Phone (903) 595-0500

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

408 S Main St
Winnsboro, TX 75494
Phone (903) 342-5799

Interoperability endpoints

  • Direct secure messaging: jcefalu160929@christushealth.direct-ci.net
  • Direct secure messaging: jeremyc@eyecaretyler.emadirect.md
  • Direct secure messaging: jcefalu828731@ahs.direct-ci.com

Organizations & group practices 7

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1306289186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-606-4733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1327 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "75701",
            "country_code": "US",
            "telephone_number": "903-606-4733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEFALU",
        "first_name": "JEREMY",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "R2073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371443805",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "693517",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8JX800",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.