Individual provider Active NPI

Jason Allen Bratcher, O.D.

  • Optometrist
  • Silver City, NM
National Provider Identifier
1790790160
Registry record updated Nov 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
568 Issued in NM
Practice address
611N Hudson St
Silver City, NM 88061-5436
Phone
(575) 538-2994
Fax
(575) 538-2996
NPI assigned
Jul 31, 2006
Last updated
Nov 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 568 NM Primary
Corneal and Contact Management Optometrist 152WC0802X 568 NM

Addresses

Primary practice location

611N Hudson St
Silver City, NM 88061-5436

Mailing address

611N Hudson St
Silver City, NM 88061-5436
Phone (575) 538-2994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20051214000458 NM Practitioner - Optometry 0244257483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

611 N Hudson St
Silver City, NM 88061-5436
Phone (575) 538-2994

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
568NMMDAthletic Trainer

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448755200000",
    "number": "1790790160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611N HUDSON ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880615436",
            "telephone_number": "575-538-2994",
            "fax_number": "575-538-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611N HUDSON ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880615436",
            "telephone_number": "575-538-2994",
            "fax_number": "575-538-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATCHER",
        "first_name": "JASON",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "568",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NM",
            "license": "568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

Verify at the official NPI Registry.