Jordan Wayne Yip, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9204T Issued in TX

Practice address

3855 Glade Road
Colleyville, TX 76034

Phone

(817) 866-6633

Fax

(817) 888-8846

NPI assigned

Jun 30, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Optometry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Lumi Eye Care PLLC

  • Optometrist
  • Colleyville, TX
  • NPI 1457967283
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1861913667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FORT DAVIS DR",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760391798",
            "telephone_number": "210-882-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 GLADE ROAD",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "76034",
            "telephone_number": "817-866-6633",
            "fax_number": "817-888-8846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 S Hulen St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761091930",
            "country_code": "US",
            "telephone_number": "817-738-2027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIP",
        "first_name": "JORDAN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2021-06-25",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9204T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Wingard
• Thomas Winters, PHARMD
• Kirstein Womack, PT, DPT
• Erica Wong
• Dreyton Wyatt, LPC
• Yk2Yk Iom, LLC
• Christianne Young, LPC
• Christine Read Young
• Jamie Ford Zacharias
• Adel A Zakhary, MD

• Optometrist in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.
• 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.