Individual provider Active NPI

Brant Hoggatt, OD

  • Optometrist
  • Elkhart, IN
National Provider Identifier
1396638680
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004574A Issued in IN
Practice address
904 Parkway Ave
Elkhart, IN 46516-9337
Phone
(574) 970-7444
NPI assigned
Jun 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004574A IN Primary

Addresses

Primary practice location

904 Parkway Ave
Elkhart, IN 46516-9337

Mailing address

904 Parkway Ave
Elkhart, IN 46516-9337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250623002410 IN Practitioner - Optometry 8426560780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Eyecare IncGroup PAC ID 5294649885, 2 clinicians

Practice addresses (Care Compare)

904 Pkwy Ave
Elkhart, IN 46516-9337
Phone (574) 970-7444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004574AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Eyecare, Inc. Optometrist CurrentSince Jun 10, 2025 Accepting new patients

Locations

904 Parkway Ave
Elkhart, IN 46516
Phone (574) 970-7444

Organizations & group practices 1

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": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1396638680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 PARKWAY AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 PARKWAY AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169337",
            "telephone_number": "574-970-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGGATT",
        "first_name": "BRANT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004574A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.