Individual provider Active NPI

Jimmy V Joseph, O.D.

  • Optometrist
  • Missouri City, TX
National Provider Identifier
1396730107
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6785TG Issued in TX
Practice address
6026 Highway 6
Missouri City, TX 77459-4163
Phone
(281) 499-2600
Fax
(281) 499-6556
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6785TG TX Primary

Addresses

Primary practice location

6026 Highway 6
Missouri City, TX 77459-4163

Mailing address

6210 Duke Trail LN
Sugar Land, TX 77479-4465
Phone (215) 479-9112

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
I20060306000232 TX Practitioner - Optometry 7113933813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5201 Hwy 6
Suite 700
Missouri City, TX 77459-4379
Phone (832) 539-6448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6785TXMDChiropractor
6785TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chung Eye Associates Optometrist PastSince Sep 1, 2014 Accepting new patients

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1396730107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 DUKE TRAIL LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794465",
            "telephone_number": "215-479-9112",
            "fax_number": "281-286-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6026 HIGHWAY 6",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594163",
            "telephone_number": "281-499-2600",
            "fax_number": "281-499-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JIMMY",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6785TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.