James B Elledge, OD, MBA, FAAO

Primary specialty

OptometristTaxonomy code 152W00000X

License

T03341 Issued in MO

Practice address

17134 Bulverde Rd Ste 107
San Antonio, TX 78247-2190

Phone

(210) 267-2686

Fax

(210) 267-2216

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Well-Edge VisionGroup PAC ID 2264816289, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

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.

• Well-Edge Vision

  • Optometrist
  • San Antonio, TX
  • NPI 1619616778
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1710993241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17134 BULVERDE RD STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782472190",
            "telephone_number": "210-267-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17134 BULVERDE RD STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782472190",
            "telephone_number": "210-267-2686",
            "fax_number": "210-267-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "JAMES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD, MBA, FAAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006941",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Marie Elkins, LCSW
• Cassandra J Elkins, DDS
• Sara Elkordy, DMD
• Ella Austin Community Center
• Naga Pranavi Ellanti, MD
• Richard Elledge, MD
• Ellen Boyle Duncan PLLC
• Ellen W Lin MD PA
• Phyllis Jean Ellena, ADVANCED PRACTICE RN
• Leslie Ann Ellenbogen, L.C.S.W.-A.C.P.

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.