Individual provider Active NPI

Carey R Fracht, O.D.

  • Optometrist
  • Jasper, TX
National Provider Identifier
1114066081
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2833T Issued in TX
Practice address
130 N Austin St
Jasper, TX 75951-4102
Phone
(409) 384-5192
NPI assigned
Feb 6, 2007
Last updated
Mar 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2833T TX Primary

Addresses

Primary practice location

130 N Austin St
Jasper, TX 75951-4102

Mailing address

130 N Austin St
Jasper, TX 75951-4102
Phone (409) 384-5192

Other identifiers 2

IdentifierTypeStateIssuer
0199080001OtherTXBLUE CROSS BLUE SHIELD
T13314OtherTXNOT CERTAIN

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
I20111227000022 TX Practitioner - Optometry 4284800178 Practice locations: Jasper, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 N Austin St
Jasper, TX 75951-4102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2833TXMDAddiction (Substance Use Disorder) Counselor
2833TTXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1114066081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N AUSTIN ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514102",
            "telephone_number": "409-384-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N AUSTIN ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514102",
            "telephone_number": "409-384-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRACHT",
        "first_name": "CAREY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2833T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0199080001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT CERTAIN",
            "identifier": "T13314",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

Verify at the official NPI Registry.