Individual provider Active NPI

James D Egbert, O. D.

  • Optometrist
  • Huber Heights, OH
National Provider Identifier
1134123722
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2855T1396 Issued in OH
Practice address
6557 Brandt Pike
Huber Heights, OH 45424-3353
Phone
(937) 236-1770
Fax
(937) 236-4006
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 2855T1396 OH Primary

Addresses

Primary practice location

6557 Brandt Pike
Huber Heights, OH 45424-3353

Mailing address

6557 Brandt Pike
Huber Heights, OH 45424-3353
Phone (937) 236-1770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120411000386 OH Practitioner - Optometry 2769427129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. James D. Egbert, Optometrist, Inc.Group PAC ID 5991740359, 4 clinicians

Practice addresses (Care Compare)

6557 Brandt Pike
Huber Heights, OH 45424-3353
Phone (937) 236-1770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2855T1396OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. James D. Egbert, Optometrist, Inc. Optometrist Past Accepting new patients

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1134123722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6557 BRANDT PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454243353",
            "telephone_number": "937-236-1770",
            "fax_number": "937-236-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6557 BRANDT PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454243353",
            "telephone_number": "937-236-1770",
            "fax_number": "937-236-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "JAMES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2855T1396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huber Heights, OH

Sources for this page

Verify at the official NPI Registry.