Individual provider Active NPI

Jacqueline Sylvia Le

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1649709734
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9154T Issued in TX
Practice address
6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone
(817) 294-2800
Fax
(817) 294-1282
NPI assigned
Jun 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9154T TX Primary

Addresses

Primary practice location

6037 Harris Pkwy
Fort Worth, TX 76132-4103

Mailing address

6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone (817) 294-2800

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
I20221129000822 TX Practitioner - Optometry 7719355577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wedgwood Eyecare PCGroup PAC ID 2961825450, 3 clinicians

Practice addresses (Care Compare)

6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone (817) 294-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9154TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wedgwood Eyecare PC Optometrist CurrentSince Aug 18, 2022 Accepting new patients

Locations

6037 Harris Pkwy
Fort Worth, TX 76132
Phone (817) 294-2800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1649709734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-294-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-294-2800",
            "fax_number": "817-294-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "JACQUELINE",
        "middle_name": "SYLVIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9154T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.