Individual provider Active NPI

Iredia Joe Ekukpe, O.D.

  • Optometrist
  • Dallas, TX
National Provider Identifier
1609827765
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6330TG Issued in TX
Practice address
655 W Illinois Ave
#911
Dallas, TX 75224-1817
Phone
(214) 941-9600
Fax
(214) 941-9623
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6330TG TX Primary

Addresses

Primary practice location

655 W Illinois Ave
#911
Dallas, TX 75224-1817

Mailing address

655 W Illinois Ave
#911
Dallas, TX 75224-1817
Phone (214) 941-9600

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
I20050502000851 TX Practitioner - Optometry 0345289096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2818 Fort Worth Ave
Dallas, TX 75211-2401
Phone (214) 941-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6330TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
United Medcare, Inc CurrentSince Oct 22, 2008 Accepting new patients
Truevision Complete Eye-Care P.a. Optometrist CurrentSince Sep 1, 2025 Accepting new patients

Locations

2818 Fort Worth Ave
Dallas, TX 75211
Phone (214) 339-6161

911 Wynnewood Village Shp Ctr
Dallas, TX 75224
Phone (214) 941-9600

Organizations & group practices 3

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609827765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W ILLINOIS AVE",
            "address_2": "#911",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752241817",
            "telephone_number": "214-941-9600",
            "fax_number": "214-941-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W ILLINOIS AVE",
            "address_2": "#911",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752241817",
            "telephone_number": "214-941-9600",
            "fax_number": "214-941-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKUKPE",
        "first_name": "IREDIA",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6330TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.