Individual provider Active NPI

Brett David Freitag, OD

  • Optometrist
  • Crystal Lake, IL
National Provider Identifier
1164037495
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011472 Issued in IL
Practice address
5006 Northwest Hwy
Crystal Lake, IL 60014-7339
Phone
(779) 205-0315
NPI assigned
Sep 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 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 046011472 IL Primary

Addresses

Primary practice location

5006 Northwest Hwy
Crystal Lake, IL 60014-7339

Mailing address

3 Shadow Creek CT
Lake in the Hills, IL 60156-5930
Phone (815) 236-7278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250801001949 WI Practitioner - Optometry 9638598857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

2860 S Green Bay Rd
Suite 250
Mount Pleasant, WI 53406-4968
Phone (262) 637-3733

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince Jun 16, 2025 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Emergency Medical & Surgical Specialists of Colorado LLC Past Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients

Locations

2860 S Green Bay Rd
Ste 250
Mount Pleasant, WI 53406
Phone (262) 637-3733

Organizations & group practices 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1164037495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SHADOW CREEK CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565930",
            "telephone_number": "815-236-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 NORTHWEST HWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147339",
            "telephone_number": "779-205-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREITAG",
        "first_name": "BRETT",
        "middle_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.