Individual provider Active NPI

Jared Sies, OD

  • Optometrist
  • Lubbock, TX
National Provider Identifier
1669236204
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11055T Issued in TX
Practice address
12210 Quaker Ave
Lubbock, TX 79424-7789
Phone
(806) 792-5900
NPI assigned
Feb 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 11055T TX Primary

Addresses

Primary practice location

12210 Quaker Ave
Lubbock, TX 79424-7789

Mailing address

63 S Rockford Dr Ste 220
Tempe, AZ 85288-6226
Phone (806) 792-5900

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
I20240314003417 TX Practitioner - Optometry 0345686101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas Eye PAGroup PAC ID 5294782389, 23 clinicians

Practice addresses (Care Compare)

12210 Quaker Ave
Lubbock, TX 79424-7789
Phone (806) 792-5900

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11055TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Eye PA Optometrist CurrentSince May 1, 2024 Accepting new patients
West Texas Eye PA Optometrist CurrentSince May 1, 2024 Accepting new patients

Locations

63 S Rockford Dr
Ste 220
Tempe, AZ 85288

3611 50th St
Lubbock, TX 79413
Phone (806) 792-5900

5109 80th St
Lubbock, TX 79424
Phone (806) 792-5900

12210 Quaker Ave
Lubbock, TX 79424
Phone (806) 792-5900

805 W Wadley Ave
Midland, TX 79705
Phone (806) 792-5900

Interoperability endpoints

  • Direct secure messaging: jared.sies.p30@direct.avp.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1669236204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 S ROCKFORD DR STE 220",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852886226",
            "telephone_number": "806-792-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12210 QUAKER AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794247789",
            "telephone_number": "806-792-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIES",
        "first_name": "JARED",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-13",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11055T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.