Individual provider Active NPI

Charles Jacob Luke, OPTOMETRIST

  • Optometrist
  • Midland, TX
National Provider Identifier
1710995493
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7331TG Issued in TX
Practice address
3415 N Loop 250 W Ste 201
Midland, TX 79707-6035
Phone
(423) 234-1795
Fax
(432) 704-5652
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7331TG TX Primary

Addresses

Primary practice location

3415 N Loop 250 W Ste 201
Midland, TX 79707-6035

Mailing address

3415 N Loop 250 W Ste 201
Midland, TX 79707-6035
Phone (423) 234-1795

Other practice location 1

1431 W 10th St
suite 5
Laurel, MS 39440-2626
Phone (601) 649-1437

Other practice location 2

1431 W 10th St
suite 5
Laurel, MS 39440-2626
Phone (601) 649-1437

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
I20111110000818 TX Practitioner - Optometry 3678599297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luke Eye Associates, LPGroup PAC ID 7214109370, 2 clinicians

Practice addresses (Care Compare)

3415 N Loop 250
Suite 201
Midland, TX 79707-6035
Phone (432) 234-1795

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7331TXMDDentist
7331TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luke Eye Associates, LP Optometrist CurrentSince Aug 24, 2011 Accepting new patients
Eye Care Associates Past Accepting new patients

Locations

3415 N Loop 250 W
Ste 201
Midland, TX 79707
Phone (423) 234-1795

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1710995493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 N LOOP 250 W STE 201",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797076035",
            "telephone_number": "423-234-1795",
            "fax_number": "432-704-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 N LOOP 250 W STE 201",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797076035",
            "telephone_number": "423-234-1795",
            "fax_number": "432-704-5652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 W 10th St",
            "address_2": "suite 5",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394402626",
            "country_code": "US",
            "telephone_number": "601-649-1437",
            "fax_number": "601-649-1431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1431 W 10th St",
            "address_2": "suite 5",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394402626",
            "country_code": "US",
            "telephone_number": "601-649-1437",
            "fax_number": "601-649-1431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUKE",
        "first_name": "CHARLES",
        "middle_name": "JACOB",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7331TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.