Active NPI
David A Berntsen, O.D., PH.D.
- Optometrist
- Houston, TX
National Provider Identifier
1285612770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6274
- Practice address
- 4401 Martin Luther King Blvd
Houston, TX 77204-2020 - Phone
- (713) 743-2020
- Fax
- (713) 743-0963
- NPI assigned
- Jan 4, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5287 | OH | |
| Optometrist | 152W00000X | 06274T | TX | |
| Optometrist | 152W00000X | 6274TG | TX | |
| Corneal and Contact Management Optometrist | 152WC0802X | 5287 | OH | |
| Optometrist | 152W00000X | 6274 | TX | Primary |
Addresses
Primary practice location
4401 Martin Luther King Blvd
Houston, TX 77204-2020
Mailing address
4401 Martin Luther King Blvd
Houston, TX 77204-2020
Phone (713) 743-2020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281270301 | Medicaid | TX | |
| 1124091-04 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06274T | TX | MD | Optometrist |
| 6274TG | TX | MD | Optometrist |
| 5287 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652745600000",
"number": "1285612770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 MARTIN LUTHER KING BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772042020",
"telephone_number": "713-743-2020",
"fax_number": "713-743-0963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 MARTIN LUTHER KING BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772042020",
"telephone_number": "713-743-2020",
"fax_number": "713-743-0963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNTSEN",
"first_name": "DAVID",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2022-05-17",
"certification_date": "2022-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "5287",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "06274T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6274TG",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "OH",
"license": "5287",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "281270301",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124091-04",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.