John Charles Haeseker, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1476 Issued in CO

Practice address

11550 Meridian Market View
Walmart Vision Center #4335
Peyton, CO 80831-8233

Phone

(719) 495-5055

Fax

(719) 495-0574

NPI assigned

May 8, 2006

Last updated

Nov 14, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CO

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

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.

• John C. Haeseker, O.D. PC

  • Optometrist
  • Peyton, CO
  • NPI 1285815332
  NPD Authorized official

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1659320752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 MERIDIAN MARKET VIEW",
            "address_2": "WALMART VISION CENTER #4335",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318233",
            "telephone_number": "719-495-5055",
            "fax_number": "719-495-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 MERIDIAN MARKET VIEW",
            "address_2": "WALMART VISION CENTER #4335",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318233",
            "telephone_number": "719-495-5055",
            "fax_number": "719-495-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAESEKER",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Peyton, CO
• Providers in Peyton, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.