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DR. MALLORY MICHELLE RICKETT OD
NPI 1104788595
Optometrist in Fort Worth, TX

Active since November 24, 2025PECOS Enrolled
655 TAYLOR ST, FORT WORTH, TX 76102(817) 289-6825 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Mallory Michelle Rickett Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MALLORY MICHELLE RICKETT OD (NPI 1104788595) is an individual optometrist in Fort Worth, Texas, licensed in Texas (11387TG) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1104788595
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. MALLORY MICHELLE RICKETTCredential: OD
Location Address655 TAYLOR STFort Worth, TX 76102-4821
Mailing Address23010 Jane RdTomball, TX 77377-3700
Phone(817) 289-6825
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 24, 2025
NPPES CertifiedNovember 24, 2025
✔ NPI 1104788595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in TX · 11387TG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
655 TAYLOR ST, Fort Worth, TX 76102
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mallory Michelle Rickett Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476047788
PECOS Enrollment IDI20251215000812
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.63 typical visit price
range $56.47 – $171.07
Typical copayment $32.40 (range $14.11 – $42.76)
Most-billed visit code 99204
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BARBARA ELLEN HYLER STIVALA OD
Optometrist
655 TAYLOR ST
FORT WORTH, TX 76102
Tarrant County (817) 289-6800
COURTNEY NICOLE CROWELL OD
Optometrist
655 TAYLOR ST
FORT WORTH, TX 76102
Tarrant County (817) 289-6800
NOOR ABUSHAGUR OD
Optometrist
655 TAYLOR ST
FORT WORTH, TX 76102
Tarrant County (817) 289-6800
SAFINAZ GAMINI OD
Optometrist
655 TAYLOR ST
FORT WORTH, TX 76102
Tarrant County (817) 289-6800
ANDREW P KEMP OD
Optometrist
655 TAYLOR ST
FORT WORTH, TX 76102
Tarrant County (817) 289-6800
ANGELA HEMBREE
Optometrist
655 TAYLOR ST
FORT WORTH, TX 76102
Tarrant County (817) 289-6800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Rickett's NPI number?

The NPI number for Mallory Rickett is 1104788595. It was assigned to this individual provider in the NPPES registry on November 24, 2025.

Where is Mallory Rickett located?

Mallory Rickett practices at 655 Taylor St, Fort Worth, TX 76102. The listed phone number is (817) 289-6825.

What is Mallory Rickett's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mallory Rickett enrolled in Medicare?

Yes. Mallory Rickett is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mallory Rickett was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.