Individual provider Active NPI

Gerald George Gerdes Jr., O.D.

  • Optometrist
  • Oakdale, LA
National Provider Identifier
1013056308
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1339527T Issued in LA
Practice address
414 E 7TH Ave
Oakdale, LA 71463-2624
Phone
(318) 335-3275
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1339527T LA Primary

Addresses

Primary practice location

414 E 7TH Ave
Oakdale, LA 71463-2624

Mailing address

414 E 7TH Ave
Oakdale, LA 71463-2624
Phone (318) 335-3275

Other identifiers 1

IdentifierTypeStateIssuer
1464619MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921000765 LA Practitioner - Optometry 7719955459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Clinic LLCGroup PAC ID 1850354713, 2 clinicians

Practice addresses (Care Compare)

2041 NW Evangeline Thruway
Lafayette, LA 70501-1925
Phone (337) 235-3160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1339527TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Clinic LLC Optometrist CurrentSince Aug 27, 2004 Accepting new patients
Kinder Eye Care Optometrist Past Accepting new patients

Locations

226 E Pinhook Rd
Lafayette, LA 70501
Phone (337) 235-3160

2041 NW Evangeline Trwy
Lafayette, LA 70501
Phone (337) 235-3160

414 E 7th Ave
Oakdale, LA 71463
Phone (318) 335-3275

2818 Bonin Rd
Youngsville, LA 70592
Phone (318) 447-0395

Networks

  • TX HMO D-SNP
  • TX HMO

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1013056308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E 7TH AVE",
            "city": "OAKDALE",
            "state": "LA",
            "postal_code": "714632624",
            "telephone_number": "318-335-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E 7TH AVE",
            "city": "OAKDALE",
            "state": "LA",
            "postal_code": "714632624",
            "telephone_number": "318-335-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDES",
        "first_name": "GERALD",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1339527T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1464619",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, LA

Sources for this page

Verify at the official NPI Registry.