Individual provider Active NPI

Bradley Alexander Hiatt, OD

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1083106991
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004187A Issued in IN
Practice address
1481 W 10TH St
Indianapolis, IN 46202-2803
Phone
(317) 554-0000
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004187A IN Primary

Addresses

Primary practice location

1481 W 10TH St
Indianapolis, IN 46202-2803

Mailing address

1481 W 10TH St
Indianapolis, IN 46202-2803
Phone (317) 554-0000

Other identifiers 1

IdentifierTypeStateIssuer
2067MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190830001451 IN Practitioner - Optometry 3577891464 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 12, 2019 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 12, 2019 Accepting new patients

Locations

13080 Grand Blvd
Ste 110
Carmel, IN 46032
Phone (317) 575-1133

14555 Hazel Dell Pkwy
Ste 120
Carmel, IN 46033
Phone (317) 706-2020

7840 E 96th St
Fishers, IN 46037
Phone (317) 595-9999

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

804 Broad Ripple Ave
Indianapolis, IN 46220
Phone (317) 257-5421

8170 Oaklandon Rd
#A
Indianapolis, IN 46236
Phone (317) 823-9985

2902 W 86th St
Ste 160
Indianapolis, IN 46268
Phone (317) 228-9163

100 S Creasy Ln
Ste 1530
Lafayette, IN 47905
Phone (765) 447-5083

2705 N Lebanon St
Ste 230
Lebanon, IN 46052
Phone (317) 773-5153

1501 W Oak St
Ste 100
Zionsville, IN 46077
Phone (317) 873-4020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1083106991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-554-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-554-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIATT",
        "first_name": "BRADLEY",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004187A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2067",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.