Individual provider Active NPI

Bernardo Behrens, OD

  • Optometrist
  • Ft Worth, TX
National Provider Identifier
1205953023
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
432 Issued in NM
Practice address
1880 Carswell Avenue
Ft Worth, TX 76127
Phone
(505) 313-6506
NPI assigned
Mar 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 006502 NY
Optometrist 152W00000X 6007T TX
Optometrist 152W00000X 432 NM Primary

Addresses

Primary practice location

1880 Carswell Avenue
Ft Worth, TX 76127

Mailing address

2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850

Other identifiers 2

IdentifierTypeStateIssuer
170420701MedicaidTX
000Q4763MedicaidNM

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
I20041123000566 TX Practitioner - Optometry 6901861517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6007TTXMDOptometrist
432NMMDPeer Specialist
6007TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brownwood Optometrists, P.C. Optometrist CurrentSince Jun 10, 2024 Accepting new patients
Hero Vision of Albuquerque LLC Optometrist Past Accepting new patients
Hero Dental of Albuquerque PC Past Accepting new patients

Locations

310 Early Blvd
Early, TX 76802
Phone (325) 643-1826

Organizations & group practices 3

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": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1205953023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "719-576-1850",
            "fax_number": "719-955-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 CARSWELL AVENUE",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "76127",
            "telephone_number": "505-313-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "BERNARDO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006502",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6007T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170420701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Q4763",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

Verify at the official NPI Registry.