Kyle Lance Hibbert, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002332 Issued in AZ

Practice address

US 191 & Sr 264
Ganado, AZ 86505-7415

Phone

(928) 755-4500

NPI assigned

Nov 10, 2011

Last updated

Sep 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY, AZ2 enrollments

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 2

Specialty

Optometry

Education

Southern California College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountain View Optometric Inc.

  • Optometrist
  • Casper, WY
  • NPI 1942918107
  Medicare reassignment NPD Authorized official
• Navajo Health Foundation-Sage Memorial Hospital, Inc.

  dba Sage Memorial Physicians

  • Rural Acute Care Hospital
  • Ganado, AZ
  • NPI 1477735777
  Medicare reassignment NPD
• Navajo Health Foundation-Sage Memorial Hospital Inc

  dba Sage Memorial Hospital

  • Critical Access Hospital Clinic/Center
  • Ganado, AZ
  • NPI 1518957398
  NPD

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1093092629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781",
            "city": "WINDOW ROCK",
            "state": "AZ",
            "postal_code": "865150781",
            "telephone_number": "307-696-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US 191 & SR 264",
            "city": "GANADO",
            "state": "AZ",
            "postal_code": "865057415",
            "telephone_number": "928-755-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBERT",
        "first_name": "KYLE",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-10",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "829",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Frank, FNP
• Shanell K Franklin
• Ganado Unified School District #20
• Devon KB Gorman
• Alphonso N. Guy
• Semegn Molla Hodes
• Jordan Rachelle Hoile, DPT
• B Noelani Hong, PHDOTRL
• Matthew Walter Hucek, MD
• Mohammad F Ilyas, MD

• Optometrist in Ganado, AZ
• Providers in Ganado, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.