Individual provider Active NPI

Brian Adam Hajovsky, M.D.

  • Ophthalmology Physician
  • Fort Worth, TX
National Provider Identifier
1942278429
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
L6926 Issued in TX
Practice address
1201 Summit Ave
Fort Worth, TX 76102-4427
Phone
(817) 332-2020
Fax
(817) 332-4797
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X L6926 TX
Ophthalmology Physician 207W00000X L6926 TX Primary

Addresses

Primary practice location

1201 Summit Ave
Fort Worth, TX 76102-4427

Mailing address

1201 Summit Ave
Fort Worth, TX 76102-4427
Phone (817) 332-2020

Other identifiers 2

IdentifierTypeStateIssuer
163952802MedicaidTX
8J0404OtherTXBCBS

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304001324 TX Practitioner - Ophthalmology 4082502760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Texas Tech University Health Science Center School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmic Partners , PAGroup PAC ID 4587578364, 14 clinicians

Practice addresses (Care Compare)

1201 Summit Ave
Fort Worth, TX 76102-4413
Phone (817) 332-2020

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
99.97
Improvement activities
40
Cost
75.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L6926TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Partners, PA Ophthalmology CurrentSince Jul 1, 2005 Accepting new patients
Ophthalmic Partners , PA Ophthalmology CurrentSince Jul 1, 2005 Accepting new patients
Retina and Vitreous of Texas PLLC Ophthalmology PastSince Jul 9, 2018 Accepting new patients

Locations

5801 Oakbend Trl
Ste 100
Fort Worth, TX 76132
Phone (817) 346-2969

1201 Summit Ave
Ft Worth, TX 76102
Phone (817) 332-2020

804 Santa Fe Dr
Weatherford, TX 76086
Phone (817) 341-5609

Interoperability endpoints

  • Direct secure messaging: ahajovsky@oafwtx.intellechartdirect.net

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1942278429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SUMMIT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024427",
            "telephone_number": "817-332-2020",
            "fax_number": "817-332-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SUMMIT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024427",
            "telephone_number": "817-332-2020",
            "fax_number": "817-332-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJOVSKY",
        "first_name": "BRIAN",
        "middle_name": "ADAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "L6926",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "L6926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163952802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8J0404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.