Individual provider Active NPI

Avni Gajjar, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1811378367
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8658 Issued in TX
Practice address
6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone
(817) 294-2800
NPI assigned
Jun 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8658 TX Primary

Addresses

Primary practice location

6037 Harris Pkwy
Fort Worth, TX 76132-4103

Mailing address

6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone (817) 294-2800

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
I20151019002329 TX Practitioner - Optometry 4284943036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wedgwood Eyecare PC 3 clinicians

Practice addresses (Care Compare)

6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone (817) 294-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8658TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wedgwood Eyecare PC Optometrist CurrentSince Jul 8, 2024 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients

Locations

5832 Boat Club Rd
Fort Worth, TX 76179
Phone (817) 237-7153

6037 Harris Pkwy
Fort Worth, TX 76132
Phone (817) 294-2800

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8329 Whitley Rd
Watauga, TX 76148
Phone (817) 431-2020

Interoperability endpoints

  • Direct secure messaging: avni.gajjar@uprisedirect.com

Organizations & group practices 4

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": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1811378367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-294-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-294-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJJAR",
        "first_name": "AVNI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.