Jack L Hostetler, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

349 Issued in AZ

Practice address

2680 S Val Vista Dr
#111
Gilbert, AZ 85295-2152

Phone

(480) 807-0288

Fax

(480) 299-7199

NPI assigned

Jun 9, 2005

Reactivated

Mar 29, 2006

Last updated

Jun 25, 2008By the provider in NPPES

Sex

Male

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 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

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.

• San Tan Eyecare PLC

  • Optometrist
  • Gilbert, AZ
  • NPI 1114101136
  Medicare reassignment NPD Authorized official
• San Tan Eye Care PLC

  • Optometrist
  • Gilbert, AZ
  • NPI 1972765907
  NPD Authorized official
• James L. Abbott, OD, PC

  • Optometrist
  • Mesa, AZ
  • NPI 1609040187
  NPD (past)
• Jonathan E Wold OD PC

  • Optometrist
  • Gilbert, AZ
  • NPI 1861658965
  NPD (past)
• Tom Sowash OD & Associates PC

  dba Visionworks

  • Optometrist
  • Chandler, AZ
  • NPI 1174627202
  NPD (past)
• Visionworks Inc

  dba Visionworks

  • Eyewear Supplier
  • Gilbert, AZ
  • NPI 1306099643
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1760486500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR",
            "address_2": "#111",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952152",
            "telephone_number": "480-807-0288",
            "fax_number": "480-299-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR",
            "address_2": "#111",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952152",
            "telephone_number": "480-807-0288",
            "fax_number": "480-299-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "JACK",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2008-06-25",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "860439395",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikolett Horvath
• Christina Hoskins
• Brittan Hosner, CNM, WHNP
• Hospice Family Care, Inc. (Gentiva II)
• Hospice of the Valley
• Geoffrey David Hostetter, A.T.C.
• Alely Hostia, OD
• Ling Zhu Hou
• Dezerrae Darling Sanchez Houk, LPC
• Tanal Houmani

• Optometrist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.