Individual provider Active NPI

Jordan Tanous, OD

  • Optometrist
  • Waco, TX
National Provider Identifier
1801313382
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9327T Issued in TX
Practice address
5001 W Waco Dr
Waco, TX 76710-7021
Phone
(888) 792-8588
NPI assigned
Aug 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9327T TX Primary

Addresses

Primary practice location

5001 W Waco Dr
Waco, TX 76710-7021

Mailing address

5001 W Waco Dr
Waco, TX 76710-7021
Phone (888) 792-8588

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
I20210802000281 TX Practitioner - Optometry 2860896669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russell E Swann M.D. PAGroup PAC ID 8729025424, 2 clinicians

Practice addresses (Care Compare)

201 Londonderry Dr
Waco, TX 76712-7902

201 Londonderry Dr
Waco, TX 76712-7931
Phone (254) 772-4499

Merit-based Incentive Payment System (MIPS)

Final score
91.73 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9327TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Russell E Swann M.D. PA CurrentSince Aug 4, 2021 Accepting new patients

Locations

201 Londonderry Dr
#O
Waco, TX 76712
Phone (254) 772-4499

201 Londonderry Dr
Waco, TX 76712
Phone (254) 772-4499

Interoperability endpoints

  • Direct secure messaging: jtanous@brazoseye.emadirect.md

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1801313382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 W WACO DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767107021",
            "telephone_number": "888-792-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 W WACO DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767107021",
            "telephone_number": "888-792-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANOUS",
        "first_name": "JORDAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9327T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.