Jason Allen Bratcher, O.D.
Individual provider Active NPI Optometrist · Silver City, NM
NPI 1790790160 · NPPES record last updated Nov 29, 2015
Key facts
- NPI
- 1790790160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 568 (NM)
- Practice address
- 611N Hudson St
Silver City, NM 88061-5436 - Phone
- (575) 538-2994
- Fax
- (575) 538-2996
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- 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
- Gila Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051214000458 | NM | Practitioner - Optometry | 0244257483 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 568 | NM | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 568 | NM | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2590482 | Medicaid | NM | |
| 78653037 | Medicaid | NM |
Other providers in Silver City, NM
- Henry M Borra
- Daja Vu Bowers
- Marsha L Bowman
- Joshua Bradley
- Amber Brandt
- Jennifer Brickey
- Isabella C Brown
- Melanie K. Brown
- Stephanie Brown
- Rebecca Brueggemann
All providers in Silver City, NM · Optometrist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.