Alicia Denee Derry, O.D.

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

7336TG Issued in TX

Practice address

321 S Henderson St
Fort Worth, TX 76104-1016

Phone

(817) 529-9949

NPI assigned

Sep 5, 2006

Last updated

Feb 29, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pediatric Eye Specialists LLP

  • Ophthalmology Physician
  • Fort Worth, TX
  • NPI 1760507149

  Optometrist

  Medicare reassignment NPD
• Specialeyes Optical, LLC

  • Optometrist
  • Denton, TX
  • NPI 1821564964
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1801999149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041016",
            "telephone_number": "817-529-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041016",
            "telephone_number": "817-529-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRY",
        "first_name": "ALICIA",
        "middle_name": "DENEE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.009254",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "7336TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Ann Derby
• Maya Derhake, MS, CGC
• John Derouin Jr.
• Dustin Clifton Derrick, M.D.
• Tiffany Ann Derrick, LPC-I
• Martin A Derusha, DO
• Mina Girgis Deryas
• Alap Desai, M.D.
• Hetal Desai
• Mita Desai, DDS

• Pediatric Optometrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.