Brandon Moderhack, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

8490T Issued in TX

Practice address

301 W Texas Ave
Baytown, TX 77520

Phone

(281) 427-7374

Fax

(281) 427-6052

NPI assigned

Mar 31, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2014

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)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment Care Compare group NPD
• Chris L Warford OD PA

  • Eyewear Supplier
  • Baytown, TX
  • NPI 1073736823

  Optometrist

  Medicare reassignment NPD
• Janet B Ogletree OD PA

  • Optometrist
  • Flower Mound, TX
  • NPI 1740313089
  NPD (past)

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1487049003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W TEXAS AVE",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775207768",
            "telephone_number": "281-427-7374",
            "fax_number": "281-427-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W TEXAS AVE",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "77520",
            "telephone_number": "281-427-7374",
            "fax_number": "281-427-6052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13550 Lakes Of Champions Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Mont Belvieu",
            "state": "TX",
            "postal_code": "775232900",
            "country_code": "US",
            "telephone_number": "832-981-7276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODERHACK",
        "first_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8490T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Minano
• Emily Minish, DPT
• Sarah Mirembe, DO
• Dovey Mitchell
• Mobile Designer Drips LLC
• Mohamed S Ahmed MD PA
• Mohammad Athari, MD, PA
• Mohammed a. Hameed M.D. PA
• Mahmoud Mohammed
• Elyssa Gabrielle Molina, D.C

• Optometrist in Baytown, TX
• Providers in Baytown, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.