Individual provider Active NPI

Tiffany Chen, OD

  • Optometrist
  • Dallas, TX
National Provider Identifier
1306299078
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9020TG Issued in TX
Practice address
4901 Windhaven Parkway
Suite 100
Dallas, TX 75056
Phone
(972) 596-2224
Fax
(972) 596-2229
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9020TG TX Primary

Addresses

Primary practice location

4901 Windhaven Parkway
Suite 100
Dallas, TX 75056

Mailing address

4901 Windhaven Parkway
Suite 100
Dallas, TX 75056
Phone (972) 596-2224

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
I20160809000435 TX Practitioner - Optometry 5799079133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliott Eye Associates PAGroup PAC ID 6507930690, 3 clinicians
Modern Vue Eyecare PLLCGroup PAC ID 8325483928, 2 clinicians

Practice addresses (Care Compare)

175 S Denton Tap Rd
Coppell, TX 75019-3204
Phone (972) 393-8600

565 Coit Rd
Suite 650
Plano, TX 75075-5889
Phone (214) 305-9395

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9020TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elliott Eye Associates PA Optometrist CurrentSince Apr 1, 2024 Accepting new patients
Modern Vue Eyecare PLLC Optometrist CurrentSince Mar 4, 2024 Accepting new patients

Locations

175 S Denton Tap Rd
Coppell, TX 75019
Phone (972) 393-8600

565 Coit Rd
Ste 650
Plano, TX 75075
Phone (214) 305-9395

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306299078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 WINDHAVEN PARKWAY",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75056",
            "telephone_number": "972-596-2224",
            "fax_number": "972-596-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 WINDHAVEN PARKWAY",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75056",
            "telephone_number": "972-596-2224",
            "fax_number": "972-596-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "TIFFANY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9020TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.