Individual provider Active NPI

Hans Oosterbaan, OD

  • Optometrist
  • Fredericksburg, TX
National Provider Identifier
1245239953
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4526TG Issued in TX
Practice address
1102 North Llano Street
Suite a
Fredericksburg, TX 78624-5449
Phone
(830) 997-0131
Fax
(866) 897-9855
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4526TG TX Primary

Addresses

Primary practice location

1102 North Llano Street
Suite a
Fredericksburg, TX 78624-5449

Mailing address

1102 North Llano Street
Suite a
Fredericksburg, TX 78624-5449
Phone (830) 997-0131

Other identifiers 1

IdentifierTypeStateIssuer
093435802MedicaidTX

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
I20060606000214 TX Practitioner - Optometry 4880605955 Reassigns benefits to 1 organization
Practice locations: Llano, TX; Boerne, TX; Fredericksburg, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

1102 N Llano St
Suite a
Fredericksburg, TX 78624-0234
Phone (830) 997-0131

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
Aeg Texas Professional PLLC Optometrist CurrentSince Dec 1, 2020 Accepting new patients
W. Steve Kroeger O.D., P.a. Optometrist Past Accepting new patients
Eye Country, PLLC Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

508 S Adams St
Fredericksburg, TX 78624
Phone (830) 997-2504

1102 N Llano St
Ste A
Fredericksburg, TX 78624
Phone (830) 997-0131

Organizations & group practices 4

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1245239953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 NORTH LLANO STREET",
            "address_2": "SUITE A",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245449",
            "telephone_number": "830-997-0131",
            "fax_number": "866-897-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 NORTH LLANO STREET",
            "address_2": "SUITE A",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245449",
            "telephone_number": "830-997-0131",
            "fax_number": "866-897-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OOSTERBAAN",
        "first_name": "HANS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4526TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093435802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.