Jeffrey Harbold Jr., DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

R2868 Issued in TX

Practice address

1720 S Beckham Ave Ste 102
Tyler, TX 75701-4437

Phone

(903) 618-2125

NPI assigned

Jul 15, 2015

Last updated

Aug 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jharbold@dermatologyassociates.emadirect.md

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.

• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group NPD
• Oasis Dermatology Group, PLLC

  dba Dermatology Clinic of McAllen

  • Dermatology Physician
  • McAllen, TX
  • NPI 1619099124
  Medicare reassignment NPD
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)
• Oasis Dermatology Starr County PLLC

  dba Dermatology Clinic of Starr County

  • Dermatology Physician
  • Rio Grande City, TX
  • NPI 1093122723
  NPD (past)

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1700260197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HARVEST HILL RD STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752305826",
            "telephone_number": "214-420-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S BECKHAM AVE STE 102",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014437",
            "telephone_number": "903-618-2125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1367 Dominion Plz",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757031013",
            "country_code": "US",
            "telephone_number": "903-618-2326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARBOLD",
        "first_name": "JEFFREY",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-15",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "R2868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Hansen, OT
• Sara Hanson, MS, RD, LD
• Sharie Happel
• Abigail Happli, PSYD
• Hannis Harbison
• Harbor Hospice 27, LP
• Harbor Hospice of Texarkana LP
• Monica Jane Hardee, MD
• Angela Harden, PA
• Jimmie Harden

• Dermatology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.

Verify at the official NPI Registry.