Individual provider Active NPI

Gerardo Escobedo, DO

  • Ophthalmology Physician
  • Midland, TX
National Provider Identifier
1790770402
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
L4925 Issued in TX
Practice address
10100 Loop 40 West
Midland, TX 79706
Phone
(432) 617-0181
Fax
(432) 563-0656
NPI assigned
Sep 19, 2005
Last updated
Feb 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 02002829 IN
Ophthalmology Physician 207W00000X 036113187 IL
Ophthalmology Physician 207W00000X L4925 TX Primary

Addresses

Primary practice location

10100 Loop 40 West
Midland, TX 79706

Mailing address

PO Box 61880
Midland, TX 79711-1880
Phone (432) 617-0181

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
I20070208000652 TX Practitioner - Ophthalmology 7214997493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard B Culbert MD PAGroup PAC ID 4981685195, 3 clinicians

Practice addresses (Care Compare)

10100 Loop 40
Premier Retina Specialists
Midland, TX 79706-2205
Phone (432) 563-0655

Merit-based Incentive Payment System (MIPS)

Final score
86.78 of 100Reported as group
Quality
73.55
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02002829INMDOphthalmology Physician
L4925TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard B Culbert MD PA Ophthalmology CurrentSince Aug 1, 2006 Accepting new patients
Talley Medical-Surgical Eye Care Associates PC Ophthalmology PastSince Jun 1, 2006 Accepting new patients
South Texas Retina Consultants, LLP Ophthalmology PastSince Jun 2, 1997 Accepting new patients

Locations

605 N Main St
Fort Stockton, TX 79735
Phone (432) 336-3662

10100 Loop 40
Midland, TX 79706
Phone (432) 617-0181

840 Central Dr
Odessa, TX 79761
Phone (432) 332-2682

Organizations & group practices 3

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1790770402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61880",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797111880",
            "telephone_number": "432-617-0181",
            "fax_number": "432-563-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 LOOP 40 WEST",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "79706",
            "telephone_number": "432-617-0181",
            "fax_number": "432-563-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBEDO",
        "first_name": "GERARDO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "02002829",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036113187",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "L4925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.