Individual provider Active NPI

Mark Philip Sherman, M.D.

  • Ophthalmology Physician
  • Lubbock, TX
National Provider Identifier
1720377799
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
Q3594 Issued in TX
Practice address
3611 50TH St
Lubbock, TX 79413-3911
Phone
(806) 792-5900
NPI assigned
Mar 30, 2011
Last updated
Jun 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Q3594 TX Primary

Addresses

Primary practice location

3611 50TH St
Lubbock, TX 79413-3911

Mailing address

5109 80TH St
Lubbock, TX 79424-3017
Phone (502) 296-7715

Other practice location 1

5109 80th St
Lubbock, TX 79424-3017
Phone (502) 296-7715

Other identifiers 1

IdentifierTypeStateIssuer
345647701MedicaidTX

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150513001206 TX Practitioner - Ophthalmology 8022338151 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Eye PA CurrentSince Jun 1, 2015 Accepting new patients
West Texas Eye PA Ophthalmology CurrentSince Jun 1, 2015 Accepting new patients
Cataract & Surgical Center of Lubbock LLC CurrentSince Oct 1, 2015 Accepting new patients
Alliance Retina of Texas, PLLC PastSince Mar 15, 2024 Accepting new patients

Locations

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

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

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

Interoperability endpoints

  • Direct secure messaging: mark.sherman.p30@direct.avp.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1720377799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 80TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243017",
            "telephone_number": "502-296-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 50TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794133911",
            "telephone_number": "806-792-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5109 80th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794243017",
            "country_code": "US",
            "telephone_number": "502-296-7715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "MARK",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "Q3594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345647701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.