Texas Retina Associates

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

TEXAS RETINA ASSOCIATES

Practice address

801 W Randol Mill Rd Ste 101
Arlington, TX 76012-2505

Phone

(817) 261-9625

NPI assigned

Aug 7, 2006

Organization subpart

No

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

Authorized official

Name

Jefferey Brockette

Title

Ceo

Phone

(214) 692-6941

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Texas Retina Associates

  • Ophthalmology Physician
  • Lubbock, TX
  • NPI 1093750853

  O20050221000018

  Same enrollment
• Texas Retina Associates

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1417999855

  O20050221000018

  Same enrollment
• Texas Retina Associates

  • Ophthalmology Physician
  • Sherman, TX
  • NPI 1467461202

  O20050221000018

  Same enrollment
• Texas Retina Associates

  • Ophthalmology Physician
  • Woodway, TX
  • NPI 1629010376

  O20050221000018

  Same enrollment
• Texas Retina Associates

  • Ophthalmology Physician
  • Plano, TX
  • NPI 1821007675

  O20050221000018

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Texas Retina Associates6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Texas Retina Associates

  • Ophthalmology Physician
  • Lubbock, TX
  • NPI 1093750853
  NPD tax ID
• Texas Retina Associates

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1417999855
  NPD tax ID
• Texas Retina Associates

  • Ophthalmology Physician
  • Sherman, TX
  • NPI 1467461202
  NPD tax ID
• Texas Retina Associates

  • Ophthalmology Physician
  • Woodway, TX
  • NPI 1629010376
  NPD tax ID
• Texas Retina Associates

  • Ophthalmology Physician
  • Plano, TX
  • NPI 1821007675
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Fuller, MD

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1811261316
  NPD
• Nikisha Ashok Kothari, M.D.

  • Ophthalmology Physician
  • Arlington, TX
  • NPI 1114366796
  NPD
• Andrew Joseph McClellan, MD

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1588935217
  NPD
• Rocio Isabel Diaz Sanjur, M.D.

  • Ophthalmology Physician
  • Rapid City, SD
  • NPI 1700204088
  NPD

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1851300792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650037",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650037",
            "telephone_number": "214-696-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W RANDOL MILL RD STE 101",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122505",
            "telephone_number": "817-261-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS RETINA ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "BROCKETTE",
        "authorized_official_first_name": "JEFFEREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-692-6941"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094850707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Texas Pain Specialists PLLC
• Texas Practitioners LLC
• Texas Premier Internal Medicine
• Texas Provision of Hope Home Care LLC
• Texas Rehabilitation Hospital of Arlington, LLC
• Texas Surgery Specialist, PLLC
• Texas Vision Care
• Texas Vision Care PLLC
• Texas Walk-in & Urgent Care PLLC
• Texaseso Incorporated

• Ophthalmology Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.