Individual provider Active NPI

Steven Hitzeman, O.D.

  • Optometrist
  • Bloomington, IN
National Provider Identifier
1407825409
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001753 Issued in IN
Practice address
800 E Atwater Ave
Bloomington, IN 47405-3635
Phone
(812) 855-4447
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001753 IN Primary

Addresses

Primary practice location

800 E Atwater Ave
Bloomington, IN 47405-3635

Mailing address

800 E Atwater Ave
Bloomington, IN 47405-3635
Phone (812) 855-4447

Other identifiers 1

IdentifierTypeStateIssuer
100357190MedicaidIN

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236643200000",
    "number": "1407825409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E ATWATER AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053635",
            "telephone_number": "812-855-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E ATWATER AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053635",
            "telephone_number": "812-855-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITZEMAN",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100357190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.