DR. JACK IBRAHIM OD
NPI 1760978571
Optometrist in Cedar Hill, TX
About Dr. Jack Ibrahim Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACK IBRAHIM OD (NPI 1760978571) is an individual optometrist in Cedar Hill, Texas, licensed in Texas (9518T) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jack Ibrahim Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jack Ibrahim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Kerrville, TX 78028
- Reassigned Medicare billing, Texas enrollment
- 404 clinicians in this Medicare group
San Diego, CA 92116
- Reassigned Medicare billing, California enrollment
- 6 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 75104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jack Ibrahim's NPI number?
The NPI number for Jack Ibrahim is 1760978571. It was assigned to this individual provider in the NPPES registry on July 3, 2018.
Where is Jack Ibrahim located?
Jack Ibrahim practices at 398 E Fm 1382, Cedar Hill, TX 75104. The listed phone number is (909) 919-6044.
What is Jack Ibrahim's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Jack Ibrahim enrolled in Medicare?
Yes. Jack Ibrahim is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jack Ibrahim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Ibrahim reassigns Medicare benefits to 2 organizations: Aeg Texas Professional PLLC (Kerrville, TX) and Meredith Walton Od, Optometric Corporation (San Diego, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Ibrahim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jack Ibrahim accept?
Health plans from Anthem Blue Cross and Blue Shield, Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 2 other insurers list Jack Ibrahim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jack Ibrahim was last updated on July 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.
# Dr. Jack Ibrahim, OD · NPI 1760978571
Optometrist provider in Cedar Hill, Texas. Individual provider, active in the CMS NPPES registry since July 3, 2018.
## Identity
- **NPI:** 1760978571 (Entity type: Individual)
- **Enumerated:** July 3, 2018
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 9518T (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 398 E FM 1382, Cedar Hill, TX 75104-6024
- **Phone:** (909) 919-6044
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Aeg Texas Professional PLLC (NPI 1457905937, Kerrville, TX); Meredith Walton Od, Optometric Corporation (NPI 1801317672, San Diego, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 3, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1760978571) · Data from the CMS NPPES public registry.