FORTSMITH PHAM (O.D.) – Optometrist, NPI 1285712612

FORTSMITH PHAM (O.D.) is a healthcare provider. based in Colleyville, Texas. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 6244TG (TX). The NPI Number for FORTSMITH PHAM (O.D.) is 1285712612

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
FORTSMITH PHAM (O.D.)
NPI
1285712612
Phone
(817) 485-3300
Address
5307 COLLEYVILLE BLVD STE 100
Enumeration Date
2 November 2006
Last Update Date
17 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
6305848045
Professional Enrollment ID
I20070208000252
Address ID
TX760345832CO5307XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,129 OPTOMETRY in TX

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Provider Addresses for FORTSMITH PHAM (O.D.)

  • Colleyville Boulevard, Colleyville, Tarrant County, Texas, 76054, United States

    COLLEYVILLE, TX 760345832

    Phone: (817) 485-3300

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $394.

Total Amount is formed as General ($394) + Research ($0) + Ownership ($0) = $394.

Last reported payment date: 2024-09-11 • Largest payer in this snapshot: Tarsus Pharmaceuticals, Inc. ($131).

Total Amount

$394

General + Research + Ownership

Payments

4

Total payment records

General Amount

$394

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-02-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070208000252IOptometryTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system3425$0
92004New patient complete exam of visual system1919$0
View full utilization report →

Insurance plans in this area (ZIP 76034)

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Reviews

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Frequently asked questions

Where can patients find FORTSMITH PHAM (O.D.)'s NPI?
You can confirm FORTSMITH PHAM (O.D.) with NPI 1285712612; it appears in the national provider directory.
Is FORTSMITH PHAM (O.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does FORTSMITH PHAM (O.D.) list a primary specialty?
If you are matching referrals, note Optometrist for FORTSMITH PHAM (O.D.). Clinical services aligned with this taxonomy classification.
Where is FORTSMITH PHAM (O.D.)'s primary listing?
We display Colleyville, Texas because that is what the record indicates for FORTSMITH PHAM (O.D.).
What if Colleyville, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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