Individual provider Active NPI

Slayton William Ebeling, O.D.

  • Optometrist
  • Dallas, TX
National Provider Identifier
1629459862
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8716TG Issued in TX
Practice address
3535 Travis St Ste 170
Dallas, TX 75204-1480
Phone
(214) 522-2661
NPI assigned
Jun 13, 2015
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8716T TX
Optometrist 152W00000X 8716TG TX Primary

Addresses

Primary practice location

3535 Travis St Ste 170
Dallas, TX 75204-1480

Mailing address

3535 Travis St Ste 170
Dallas, TX 75204-1480
Phone (214) 522-2661

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sebeling@directaddress.net

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
I20150820012241 TX Practitioner - Optometry 5698080554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T. Jeff Russell, M.D., P.aGroup PAC ID 4486618543, 4 clinicians

Practice addresses (Care Compare)

3535 Travis St
Suite 170
Dallas, TX 75204-1480
Phone 2145222661116

Merit-based Incentive Payment System (MIPS)

Final score
90.76 of 100Reported as group
Quality
95
Improvement activities
40
Cost
75.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8716TTXMDOptometrist
8716TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
T. Jeff Russell, M.D., P.a CurrentSince Jun 28, 2015 Accepting new patients

Locations

3535 Travis St
Ste 170
Dallas, TX 75204
Phone (214) 522-2661

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": "1434153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1629459862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 TRAVIS ST STE 170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041480",
            "telephone_number": "214-522-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 TRAVIS ST STE 170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041480",
            "telephone_number": "214-522-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBELING",
        "first_name": "SLAYTON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-13",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8716T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8716TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sebeling@directaddress.net",
            "affiliation": "N",
            "address_1": "3535 Travis St Ste 170",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752041480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.