Individual provider Active NPI

Richard W Hart, O.D.

  • Optometrist
  • Cheyenne, WY
National Provider Identifier
1750445342
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
246 Issued in AK
Practice address
2360 E Pershing Blvd
Cheyenne, WY 82001-5356
Phone
(907) 738-1159
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 246 AK Primary

Addresses

Primary practice location

2360 E Pershing Blvd
Cheyenne, WY 82001-5356

Mailing address

2360 E Pershing Blvd
Cheyenne, WY 82001-5356
Phone (907) 738-1159

Other identifiers 1

IdentifierTypeStateIssuer
OD1465MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, ID2 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

Enrollment IDStateProvider typePAC IDDetails
I20240118003882 OR Practitioner - Optometry 2567495674
I20251114003334 ID Practitioner - Optometry 2567495674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amplify Optometry of America PLLCGroup PAC ID 3072050186, 3 clinicians

Practice addresses (Care Compare)

2550 S 25TH
Idaho Falls, ID 83404-6507
Phone (208) 552-7323

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
246AKMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amplify Optometry of America PLLC Optometrist CurrentSince Oct 1, 2025 Accepting new patients
Amplify Optometry of America PLLC Optometrist CurrentSince Oct 1, 2025 Accepting new patients

Locations

2550 S 25th E
Idaho Falls, ID 83404
Phone (208) 552-7323

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1750445342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "907-738-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "907-738-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD1465",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.