Individual provider Active NPI

Gary G. Hauser, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1023016870
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-007459 Issued in IL
Practice address
3125 S Ashland Ave
Suite 204
Chicago, IL 60608-6252
Phone
(773) 890-1100
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-007459 IL Primary

Addresses

Primary practice location

3125 S Ashland Ave
Suite 204
Chicago, IL 60608-6252

Mailing address

3125 S Ashland Ave
Suite 204
Chicago, IL 60608-6252
Phone (773) 890-1100

Other identifiers 2

IdentifierTypeStateIssuer
410041869OtherRAILROAD MEDICARE
046007459MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-007459ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Eye Care, LLC Optometrist CurrentSince Aug 1, 2018 Accepting new patients

Locations

3125 S Ashland Ave
Ste 204
Chicago, IL 60608
Phone (773) 890-1100

Organizations & group practices 1

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1023016870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 S ASHLAND AVE",
            "address_2": "SUITE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606086252",
            "telephone_number": "773-890-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 S ASHLAND AVE",
            "address_2": "SUITE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606086252",
            "telephone_number": "773-890-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSER",
        "first_name": "GARY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410041869",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007459",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.