Individual provider Active NPI

Jonathan Nicholas Valamides, O.D.

  • Optometrist
  • Lake Worth, TX
National Provider Identifier
1790984789
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7079T Issued in TX
Practice address
6060 Azle Ave. Suite 500
Lake Worth, TX 76135
Phone
(817) 546-6000
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7079T TX Primary

Addresses

Primary practice location

6060 Azle Ave. Suite 500
Lake Worth, TX 76135

Mailing address

5107 Andalusia TRL
Arlington, TX 76017-3131
Phone (817) 874-7201

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
I20110722000615 TX Practitioner - Optometry 2860660511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7604 Denton Hwy
Suite 208
Watauga, TX 76148-2477
Phone (817) 503-7997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7079TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan N. Valamides, O.D., P.a. Optometrist CurrentSince Jul 1, 2018 Accepting new patients

Locations

7604 Denton Hwy
Ste 208
Watauga, TX 76148
Phone (817) 503-7997

Organizations & group practices 1

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1790984789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 ANDALUSIA TRL",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760173131",
            "telephone_number": "817-874-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 AZLE AVE. SUITE 500",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "76135",
            "telephone_number": "817-546-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALAMIDES",
        "first_name": "JONATHAN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7079T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

Verify at the official NPI Registry.