Individual provider Active NPI

Jessica Renee Trichel, O.D.

  • Optometrist
  • Texarkana, TX
National Provider Identifier
1376899633
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8014T Issued in TX
Practice address
1727 Galleria Oaks Dr
Texarkana, TX 75503-4648
Phone
(903) 792-2020
NPI assigned
Jul 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2678 AR
Optometrist 152W00000X 8014T TX Primary
Optometrist 152W00000X 2730 OK

Addresses

Primary practice location

1727 Galleria Oaks Dr
Texarkana, TX 75503-4648

Mailing address

1727 Galleria Oaks Dr
Texarkana, TX 75503-4648
Phone (903) 792-2020

Other identifiers 3

IdentifierTypeStateIssuer
8014TOtherTXSTATE LICENSE NUMBER
2730OtherARSTATE LICENSE NUMBER
2730OtherOKSTATELICENSE

Other names 1

  • Jessica Renee Gandy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120816000795 TX Practitioner - Optometry 2365698768 Reassigns benefits to 2 organizations
I20140804001202 LA Practitioner - Optometry 2365698768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 E New Boston Rd
Suite E
Nash, TX 75569-2714
Phone (903) 741-7720

Merit-based Incentive Payment System (MIPS)

Final score
94.02 of 100Reported as group
Quality
100
Improvement activities
40
Cost
80.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2730OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Renee Trichel O D PLLC Optometrist CurrentSince Feb 17, 2017 Accepting new patients
Wiggins Eye Center, PLLC CurrentSince Jul 3, 2017 Accepting new patients
Eye Centers of North Texas, PLLC PastSince Jul 3, 2017 Accepting new patients

Locations

300 E New Boston Rd
Ste E
Nash, TX 75569
Phone (903) 741-7720

1727 Galleria Oaks Dr
Texarkana, TX 75503
Phone (214) 360-4959

Organizations & group practices 4

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": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1376899633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034648",
            "telephone_number": "903-792-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034648",
            "telephone_number": "903-792-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICHEL",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2678",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8014T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "8014T",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "2730",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATELICENSE",
            "identifier": "2730",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GANDY",
            "middle_name": "RENEE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.