Individual provider Active NPI

Brian Edward Cherry, O.D.

  • Optometrist
  • Fort Stockton, TX
National Provider Identifier
1649523416
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8007TG Issued in TX
Practice address
605 N. Main
Fort Stockton, TX 79735
Phone
(432) 336-3662
Fax
(432) 336-7806
NPI assigned
Oct 18, 2012
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8007TG TX Primary

Addresses

Primary practice location

605 N. Main
Fort Stockton, TX 79735

Mailing address

P.O. Box 1568
Fort Stockton, TX 79735
Phone (432) 336-3662

Other identifiers 1

IdentifierTypeStateIssuer
267587YNE2OtherTXMEDICARE GROUP MEMBER PTAN

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
I20130228000044 TX Practitioner - Optometry 2668627449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas EyecareGroup PAC ID 7214194554, 3 clinicians

Practice addresses (Care Compare)

605 N Main St
Fort Stockton, TX 79735-5625
Phone (432) 336-3662

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8007TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Eyecare Optometrist CurrentSince Nov 1, 2016 Accepting new patients
Med Southwest, PLLC Optometrist Past Accepting new patients

Locations

605 N Main St
Fort Stockton, TX 79735
Phone (432) 336-3662

611 S Oak St
Pecos, TX 79772
Phone (432) 280-2020

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, 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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1649523416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1568",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-3662",
            "fax_number": "432-336-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N. MAIN",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-3662",
            "fax_number": "432-336-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8007TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP MEMBER PTAN",
            "identifier": "267587YNE2",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stockton, TX

Sources for this page

Verify at the official NPI Registry.