Individual provider Active NPI

Darren Hatch, OD

  • Optometrist
  • Rexburg, ID
National Provider Identifier
1487681292
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-962 Issued in ID
Practice address
49 E 1St S
Rexburg, ID 83440-1966
Phone
(208) 356-4444
Fax
(208) 356-4445
NPI assigned
Jun 27, 2006
Last updated
Aug 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-962 ID Primary

Addresses

Primary practice location

49 E 1St S
Rexburg, ID 83440-1966

Mailing address

49 E 1St S
Pobox 577
Rexburg, ID 83440-1966
Phone (208) 356-4444

Other identifiers 1

IdentifierTypeStateIssuer
804086300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20100614000793 ID Practitioner - Optometry 2769536739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rexburg Vision CenterGroup PAC ID 1153475124, 3 clinicians

Practice addresses (Care Compare)

49 E 1St
Rexburg, ID 83440-1966
Phone (208) 356-4444

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-962IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rexburg Vision Center Optometrist CurrentSince Sep 24, 1999 Accepting new patients

Locations

49 E 1st S
Rexburg, ID 83440
Phone (208) 356-4444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1487681292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 E 1ST S",
            "address_2": "POBOX 577",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401966",
            "telephone_number": "208-356-4444",
            "fax_number": "208-356-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 E 1ST S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401966",
            "telephone_number": "208-356-4444",
            "fax_number": "208-356-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCH",
        "first_name": "DARREN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804086300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.