Individual provider Active NPI

Braden Christian Hirstein, OD

  • Optometrist
  • Avondale, AZ
National Provider Identifier
1760051064
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002502 Issued in AZ
Practice address
10750 W McDowell Rd Ste A100
Avondale, AZ 85392-5961
Phone
(623) 877-3007
NPI assigned
Jun 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002502 AZ Primary

Addresses

Primary practice location

10750 W McDowell Rd Ste A100
Avondale, AZ 85392-5961

Mailing address

10350 W McDowell Rd Apt 1215
Avondale, AZ 85392-4814
Phone (219) 771-8636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210713000344 AZ Practitioner - Optometry 5890197990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adam J Lee PCGroup PAC ID 6709009731, 3 clinicians

Practice addresses (Care Compare)

10750 W McDowell Rd
Suite A100
Avondale, AZ 85392-5961
Phone (623) 877-3007

4236 N Verrado Way
Suite 103
Buckeye, AZ 85396-7595
Phone (623) 792-1955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OPT-002502AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam J. Lee, PC Optometrist CurrentSince Jun 28, 2021 Accepting new patients
Lilien Vogl OD PC Past Accepting new patients

Locations

10750 W McDowell Rd
Ste A100
Avondale, AZ 85392
Phone (623) 877-3007

4236 N Verrado Way
Ste 103
Buckeye, AZ 85396
Phone (623) 792-1955

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, 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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1760051064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 W MCDOWELL RD APT 1215",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924814",
            "telephone_number": "219-771-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD STE A100",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925961",
            "telephone_number": "623-877-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSTEIN",
        "first_name": "BRADEN",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.