Craig T Hentzel, OD

Key facts

NPI

1477523850

Entity type

Individual (NPI type 1)

Primary specialty

Optometrist 152W00000X

License

05067TG (TX)

Practice address

5001 N Piedras St
VA Clinic
El Paso, TX 79930-4210

Phone

(915) 564-6195

Fax

(915) 564-7940

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

No

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.

• Visione 360 PA Ophthalmology Physician · El Paso, TX · NPI 1184866808
  Medicare reassignment Care Compare group NPD TX
• Total Care PLLC Ophthalmology Physician · El Paso, TX · NPI 1487285656
  Medicare reassignment NPD OPTOMETRIST · TX
• Real Optics Inc Eyewear Supplier · Ames, IA · NPI 1699983403
  NPD (past)
• Real Optics Inc Eyewear Supplier · Des Moines, IA · NPI 1952510703
  NPD (past)

Medicare Care Compare profile

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Visione 360 PA (3 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 21, 2009.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1477523850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 N PIEDRAS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799304210",
            "telephone_number": "915-564-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 N PIEDRAS ST",
            "address_2": "VA CLINIC",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799304210",
            "telephone_number": "915-564-6195",
            "fax_number": "915-564-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTZEL",
        "first_name": "CRAIG",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05067TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120568405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in El Paso, TX · Optometrist in Texas