Active NPI
Brett David Freitag, OD
- Optometrist
- Crystal Lake, IL
National Provider Identifier
1164037495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046011472
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 LLC
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
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoptikal LLC | Optometrist | Current | 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.
-
- Eyewear Supplier
- Dixon, IL
- NPI 1699331082
-
- Eyewear Supplier
- Coeur D Alene, ID
- NPI 1063078442
-
- Eyewear Supplier
- West Jordan, UT
- NPI 1407412885
-
- Eyewear Supplier
- Missoula, MT
- NPI 1417513896
-
- Eyewear Supplier
- Bismarck, ND
- NPI 1518601483
-
- Eyewear Supplier
- Marquette, MI
- NPI 1578129094
-
- Eyewear Supplier
- Aberdeen, SD
- NPI 1588220958
-
- Eyewear Supplier
- Dubuque, IA
- NPI 1588220974
-
- Eyewear Supplier
- Saint Cloud, MN
- NPI 1942866371
-
- Eyewear Supplier
- Grand Island, NE
- NPI 1952967325
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.