Individual provider Active NPI

Jerry Duane Hyder, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1043334063
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3183T Issued in TX
Practice address
515 Bay Area Blvd
300
Houston, TX 77058-2602
Phone
(281) 488-0066
Fax
(281) 488-0601
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3183T TX Primary

Addresses

Primary practice location

515 Bay Area Blvd
300
Houston, TX 77058-2602

Mailing address

515 Bay Area Blvd
300
Houston, TX 77058-2602
Phone (281) 488-0066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120821000754 TX Practitioner - Optometry 1557518859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 Bay Area Blvd
Suite 300
Houston, TX 77058-2666
Phone (281) 488-0066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3183TXMDBehavioral Analyst
3183TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hyder Inc Optometrist CurrentSince May 20, 2012 Accepting new patients

Locations

515 Bay Area Blvd
Ste 300
Houston, TX 77058
Phone (281) 488-0066

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043334063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BAY AREA BLVD",
            "address_2": "300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582602",
            "telephone_number": "281-488-0066",
            "fax_number": "281-488-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BAY AREA BLVD",
            "address_2": "300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582602",
            "telephone_number": "281-488-0066",
            "fax_number": "281-488-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDER",
        "first_name": "JERRY",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3183T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.