Individual provider Active NPI

Ellis R Jones, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1881627628
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
04102 Issued in TX
Practice address
6300 Oakmont Blvd
Fort Worth, TX 76132-2807
Phone
(817) 294-2010
Fax
(817) 738-7724
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 04102 TX Primary

Addresses

Primary practice location

6300 Oakmont Blvd
Fort Worth, TX 76132-2807

Mailing address

6300 Oakmont Blvd
Fort Worth, TX 76132-2807
Phone (817) 294-2010

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
I20070227000716 TX Practitioner - Optometry 0840392569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6300 Oakmont Blvd
Suite a
Fort Worth, TX 76132-2844
Phone (817) 294-2010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04102TXMDOptometrist
4102TXMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Ellis R Jones and Associates Optometrist CurrentSince Oct 1, 2016 Accepting new patients

Locations

6300 Oakmont Blvd
Ste A
Fort Worth, TX 76132
Phone (817) 294-2010

6300 Oakmont Blvd
Ft Worth, TX 76132
Phone (817) 263-6572

Organizations & group practices 1

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1881627628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 OAKMONT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322807",
            "telephone_number": "817-294-2010",
            "fax_number": "817-738-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 OAKMONT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322807",
            "telephone_number": "817-294-2010",
            "fax_number": "817-738-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ELLIS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "04102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.