Individual provider Active NPI

Richard Beauregard Jenkins, MD

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1780950899
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
Q8729 Issued in TX
Practice address
15655 Cypress Wood Medical Dr Ste 100
Houston, TX 77014-1487
Phone
(713) 442-1700
NPI assigned
Mar 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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 Q8729 TX Primary

Addresses

Primary practice location

15655 Cypress Wood Medical Dr Ste 100
Houston, TX 77014-1487

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

106 Vision Park Blvd
Shenandoah, TX 77384-3000
Phone (713) 442-1800

Other practice location 2

13105 Wortham Center Dr
Houston, TX 77065-5611
Phone (713) 442-4000

Other identifiers 2

IdentifierTypeStateIssuer
382589503MedicaidTX
382589504MedicaidTX

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
I20161029000028 TX Practitioner - Ophthalmology 6901184795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Medical School at Houston, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

15655 Cypress Wood Medical Dr
Suite 100
Houston, TX 77014-1487
Phone (713) 442-1700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q8729TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Ophthalmology CurrentSince Feb 1, 2021 Accepting new patients
K S Management Services LLC Past Accepting new patients

Locations

13105 Wortham Center Dr
Bldg A
Houston, TX 77065

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

13105 Wortham Center Dr
Houston, TX 77065
Phone (713) 442-4000

15655 Cypress Wood Medical Dr
Houston, TX 77014
Phone (713) 442-1700

15655 Cypress Wood Medical Dr
Ste 100
Houston, TX 77014
Phone (713) 442-1700

19926 Northwest Fwy
Jersey Village, TX 77065
Phone (346) 674-2500

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

106 Vision Park Blvd
Shenandoah, TX 77384
Phone (713) 442-1800

Interoperability endpoints

  • Direct secure messaging: rjenkins35138@direct.kelsey-seybold.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": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1780950899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15655 CYPRESS WOOD MEDICAL DR STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770141487",
            "telephone_number": "713-442-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Vision Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773843000",
            "country_code": "US",
            "telephone_number": "713-442-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13105 Wortham Center Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770655611",
            "country_code": "US",
            "telephone_number": "713-442-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "RICHARD",
        "middle_name": "BEAUREGARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-23",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "Q8729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382589503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382589504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.