Active NPI
Jeffrey L Bohn, M.D.
- Ophthalmology Physician
- Tyler, TX
National Provider Identifier
1952308678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- K1781
- Practice address
- 1424 East Front
Tyler, TX 75702-8501 - Phone
- (903) 595-4144
- Fax
- (903) 596-7541
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | K1781 | TX | Primary |
Addresses
Primary practice location
1424 East Front
Tyler, TX 75702-8501
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5220532 | Other | TX | AETNA |
| 89V981 | Other | TX | BLUE CROSS BLUE SHIELD |
| 129098306 | Medicaid | TX | |
| 129098304 | Medicaid | TX | |
| 1477891 | Other | TX | UNITED HEALTHCARE |
| P02098854 | Other | TX | MEDICARE RAIL ROAD |
| 704966 | Other | TX | MEDICARE |
| 2061748 | Other | TX | CIGNA |
| 609159 | Other | TX | FIRST HEALTH |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients |
Locations
1705 Judson Rd
Longview, TX 75601
Phone (903) 758-4421
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
1424 E Front St
Tyler, TX 75702
Phone (903) 595-4167
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1952308678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 846098",
"city": "DALLAS",
"state": "TX",
"postal_code": "752846098",
"telephone_number": "903-324-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 EAST FRONT",
"city": "TYLER",
"state": "TX",
"postal_code": "757028501",
"telephone_number": "903-595-4144",
"fax_number": "903-596-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHN",
"first_name": "JEFFREY",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "K1781",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5220532",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "89V981",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129098306",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129098304",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1477891",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAIL ROAD",
"identifier": "P02098854",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "704966",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2061748",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "609159",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.