Individual provider Active NPI

Donte Hicks, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1528474996
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8418TG Issued in TX
Practice address
2500 Circle Dr
Fort Worth, TX 76119-8138
Phone
(817) 702-7340
NPI assigned
Jul 7, 2014
Last updated
Mar 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8418TG TX Primary

Addresses

Primary practice location

2500 Circle Dr
Fort Worth, TX 76119-8138

Mailing address

PO Box 732973
Dallas, TX 75373-2973
Phone (817) 702-8450

Other practice location 1

3301 Stalcup Rd
Fort Worth, TX 76119-1726
Phone (817) 702-1100

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
I20160825000600 TX Practitioner - Optometry 0143515486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8418TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince Jan 14, 2019 Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

5001 Mesa Springs Dr
Fort Worth, TX 76123
Phone (817) 702-0400

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

2500 Circle Dr
Ft Worth, TX 76119
Phone (817) 702-7340

3301 Stalcup Rd
Ft Worth, TX 76119
Phone (817) 920-7150

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1528474996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732973",
            "telephone_number": "817-702-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CIRCLE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761198138",
            "telephone_number": "817-702-7340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 Stalcup Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761191726",
            "country_code": "US",
            "telephone_number": "817-702-1100",
            "fax_number": "817-920-0729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "DONTE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8418TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.