Individual provider Active NPI

Jeffrey R Crabtree, O.D.

  • Optometrist
  • Lake Worth, TX
National Provider Identifier
1861573099
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6990T Issued in TX
Practice address
6921 Foster Dr
Lake Worth, TX 76135-2818
Phone
(817) 439-9455
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6990T TX Primary

Addresses

Primary practice location

6921 Foster Dr
Lake Worth, TX 76135-2818

Mailing address

6921 Foster Dr
Lake Worth, TX 76135-2818
Phone (817) 439-9455

Other identifiers 2

IdentifierTypeStateIssuer
468430ZSWLOtherTXMEDICARE ID(S) ASSOCIATED WITH A REASSIGNMENT OF BENEFITS
6990TOtherTXOPTOMETRIC LICENSE

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
I20071127000382 TX Practitioner - Optometry 5294823381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6921 Foster Dr
Lake Worth, TX 76135-2818
Phone (817) 439-9455

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6990TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Worth Premier Eye Care PLLC Optometrist CurrentSince Jan 4, 2016 Accepting new patients
Michael D Conte Odpc Optometrist Past Accepting new patients
Michael D. Conte PC Optometrist PastSince Mar 30, 2016 Accepting new patients

Organizations & group practices 3

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1861573099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6921 FOSTER DR",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352818",
            "telephone_number": "817-439-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6921 FOSTER DR",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352818",
            "telephone_number": "817-439-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRABTREE",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6990T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID(S) ASSOCIATED WITH A REASSIGNMENT OF BENEFITS",
            "identifier": "468430ZSWL",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIC LICENSE",
            "identifier": "6990T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

Verify at the official NPI Registry.