Active NPI
Jack Stephen Creagmile, MD
- Glaucoma Specialist (Ophthalmology) Physician
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Glaucoma Specialist (Ophthalmology) Physician
- License
- A193595
- Practice address
- 11370 Anderson St # 1800
Loma Linda, CA 92354-3450 - Phone
- (909) 558-2154
- NPI assigned
- Mar 28, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A193595 | CA | |
| Glaucoma Specialist (Ophthalmology) Physician | 207WX0009X | A193595 | CA | Primary |
Addresses
Primary practice location
11370 Anderson St # 1800
Loma Linda, CA 92354-3450
Mailing address
11370 Anderson St # 1800
Loma Linda, CA 92354-3450
Phone (909) 558-2154
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Rush Medical College of Rush University, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11234 Anderson St
Loma Linda, CA 92354-2804
11370 Anderson St
Loma Linda, CA 92354-3450
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000
4244 Riverwalk Pkwy
Suite 100
Riverside, CA 92505-3372
Phone (909) 558-2154
81 Highland Springs Ave
Beaumont, CA 92223-3170
Phone (909) 558-4000
8599 Haven Ave
Suite 102And210
Rancho Cucamonga, CA 91730-4849
Phone (909) 558-2806
File Number
Suite 54701
Los Angeles, CA 90074-4701
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 54 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A193595 | CA | MD | Glaucoma Specialist (Ophthalmology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Regents of the University of California | Ophthalmology | Current | Accepting new patients |
| Faculty Physicians and Surgeons of Llusm | Ophthalmology | Current | Accepting new patients |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients |
Locations
81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830
850 Health Sciences Rd
Irvine, CA 92617
Phone (949) 824-0606
11370 Anderson St
#1800
Loma Linda, CA 92354
Phone (909) 558-2154
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700
101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054
4244 Riverwalk Pkwy
Ste 100
Riverside, CA 92505
Phone (909) 558-2154
2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750
Interoperability endpoints
- jcreagmile1262010@direct.llu.edu
Organizations & group practices 6
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Apple Valley, CA
- NPI 1205009917
-
dba UCI Ophthalmology Group
- Ophthalmology Physician
- Orange, CA
- NPI 1871541953
-
- Ophthalmology Physician
- Loma Linda, CA
- NPI 1437109469
-
- Medical Toxicology (Emergency Medicine) Physician
- San Bernardino, CA
- NPI 1487124798
-
- Family Medicine Physician
- Moreno Valley, CA
- NPI 1558788331
-
- Orthopaedic Surgery Physician
- Loma Linda, CA
- NPI 1275582918
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Moreno Valley, CA
- NPI 1821159195
-
- General Acute Care Hospital
- Loma Linda, CA
- NPI 1194731935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1659909497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11370 ANDERSON ST # 1800",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543450",
"telephone_number": "909-558-2154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11370 ANDERSON ST # 1800",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543450",
"telephone_number": "909-558-2154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREAGMILE",
"first_name": "JACK",
"middle_name": "STEPHEN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-28",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A193595",
"primary": false
},
{
"code": "207WX0009X",
"taxonomy_group": "",
"desc": "Ophthalmology, Glaucoma Specialist",
"state": "CA",
"license": "A193595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.