Individual provider Active NPI

Lyle Eric Freedman, MD

  • Ophthalmology Physician
  • Ft Worth, TX
National Provider Identifier
1306831037
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MDG2369 Issued in TX
Practice address
11803 S Freeway
Ste 114
Ft Worth, TX 76115
Phone
(817) 551-5600
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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 MDG2369 TX Primary

Addresses

Primary practice location

11803 S Freeway
Ste 114
Ft Worth, TX 76115

Mailing address

PO Box 6426
Fort Worth, TX 76115-0426
Phone (817) 551-5600

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
I20080725000547 TX Practitioner - Ophthalmology 3577636372 Practice locations: Burleson, TX

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Medical Branch at Galveston, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11803 S Fwy
Suite 114
Burleson, TX 76028-7028

11803 S Fwy 114
Burleson, TX 76028-7028
Phone (817) 551-5600

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery157
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDG2369TXMDOphthalmology Physician

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1306831037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6426",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761150426",
            "telephone_number": "817-551-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 S FREEWAY",
            "address_2": "STE 114",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "76115",
            "telephone_number": "817-551-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "LYLE",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "MDG2369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

Verify at the official NPI Registry.