Alisa Kay Brogden, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1533-563T Issued in LA

Practice address

5848 Line Ave
Shreveport, LA 71106-1532

Phone

(318) 865-0017

Fax

(318) 868-4738

NPI assigned

Aug 17, 2006

Last updated

Apr 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA, SD2 enrollments

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 2

Specialty

Optometry

Education

Southern College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holec and Young Eye Care, LLPGroup PAC ID 6103807698, 5 clinicians

Practice addresses (Care Compare)

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

• Holec and Young Eye Care, LLP

  • Optometrist
  • Rapid City, SD
  • NPI 1225090459
  Medicare reassignment Care Compare group NPD
• Taylor Eye Care, LLC

  dba Stonewall Eye Care

  • Optometrist
  • Stonewall, LA
  • NPI 1215398631
  Medicare reassignment NPD
• Look Eyecare LLC

  • Optometrist
  • Shreveport, LA
  • NPI 1043819378
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1598878860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711061532",
            "telephone_number": "318-865-0017",
            "fax_number": "318-868-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711061532",
            "telephone_number": "318-865-0017",
            "fax_number": "318-868-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGDEN",
        "first_name": "ALISA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1533-563T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1715204",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Hart Brockman
• Ross David Brockman, DMD
• Ashley Broden, PHARM D
• Myranda Brodsky, DO
• Adrianne Baxter Brogan
• Neil W Brogden, OD
• Brooks Personal Care Attendant Service LLC
• Brooks Personal Care Attendant Service, LLC
• Brooks Reliable Transportation LLC
• Alexander Brooks

• Optometrist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.