NPIMap

Organization Active NPI

Cornea Associates of Texas PA

  • Ophthalmology Physician
  • Fort Worth, TX
National Provider Identifier
1386740876
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CORNEA ASSOCIATES OF TEXAS PA
Practice address
1101 6TH Ave
Suite 100
Fort Worth, TX 76104-4306
Phone
(817) 850-9282
Fax
(817) 850-9218
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Authorized official

Name
Tyrone McCall, MDNPI 1629006036
Title
Partner
Phone
(214) 692-0146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1101 6TH Ave
Suite 100
Fort Worth, TX 76104-4306

Mailing address

PO Box 730486
Dallas, TX 75373-0486
Phone (972) 791-1224

Other identifiers 2

IdentifierTypeStateIssuer
0071PCOtherTXBCBS
1845851 02MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070215000155 TX Part B Supplier - Clinic/Group Practice 5496757718 Receives reassigned benefits from 11 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Plano, TX; Rockwall, TX; Fort Worth, TX; Dallas, TX

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2112028Cornea Associates of Texas1101 6TH Avenue, Suite 100, Fort Worth, TX 76104Certificate of waiverApr 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
Cornea Associates of Texas PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1386740876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730486",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753730486",
            "telephone_number": "972-791-1224",
            "fax_number": "972-819-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 6TH AVE",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044306",
            "telephone_number": "817-850-9282",
            "fax_number": "817-850-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNEA ASSOCIATES OF TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "214-692-0146",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0071PC",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1845851 02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.