Individual provider Active NPI

Bethany Hilterman Brady, O.D.

  • Optometrist
  • Erie, PA
National Provider Identifier
1841206372
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001062 Issued in PA
Practice address
1600 Peninsula Dr Ste 15
Erie, PA 16505-4261
Phone
(814) 920-5010
Fax
(814) 920-5070
NPI assigned
Aug 1, 2006
Last updated
Jan 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001062 PA Primary

Addresses

Primary practice location

1600 Peninsula Dr Ste 15
Erie, PA 16505-4261

Mailing address

7376 Garfield Ave
Harborcreek, PA 16421-1405
Phone (814) 873-0792

Other identifiers 1

IdentifierTypeStateIssuer
0076225210002MedicaidPA

Other names 1

  • Dr. Bethany Marie Hilterman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101109000608 PA Practitioner - Optometry 4385839976 Reassigns benefits to 1 organization
Practice locations: Erie, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 Peninsula Dr
Suite 15
Erie, PA 16505-4261
Phone (814) 920-5010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001062PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visualeyes, PLLC Optometrist CurrentSince Nov 18, 2021 Accepting new patients
Dr. Bethany H. Brady and Associates Optometrist PastSince Jan 20, 1999 Accepting new patients

Locations

1600 Peninsula Dr
Ste 15
Erie, PA 16505
Phone (814) 920-5010

Interoperability endpoints

  • Direct secure messaging: bethany.brady@uprisedirect.com

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1841206372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7376 GARFIELD AVE",
            "city": "HARBORCREEK",
            "state": "PA",
            "postal_code": "164211405",
            "telephone_number": "814-873-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PENINSULA DR STE 15",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054261",
            "telephone_number": "814-920-5010",
            "fax_number": "814-920-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "BETHANY",
        "middle_name": "HILTERMAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076225210002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "HILTERMAN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.