Raelyn Ottenbreit, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8731TG Issued in TX

Practice address

9725 Datapoint Dr
San Antonio, TX 78229-2384

Phone

(210) 930-8163

NPI assigned

Aug 17, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Optometry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of the Incarnate WordGroup PAC ID 9234310301, 25 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• University of the Incarnate Word

  • Optometrist
  • San Antonio, TX
  • NPI 1003129784
  Medicare reassignment Care Compare group NPD
• University of the Incarnate Word

  • Family Nurse Practitioner
  • San Antonio, TX
  • NPI 1033591706
  NPD

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1922553130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 DATAPOINT DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292384",
            "telephone_number": "210-930-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 DATAPOINT DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292384",
            "telephone_number": "210-930-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENBREIT",
        "first_name": "RAELYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8731TG",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "8731TG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TX",
            "license": "8731TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergio Otero, CNIM
• Enerel Otgonbayar, DDS
• Diane Renee Otness, DPT
• Megan Otoole, D.O.
• Kristen Elizabeth Ott, MD
• Gregory T Otterman, D.C.
• Jeffrey N Ottmers, MD
• Leah Otto, DNP, AGPCNP-BC
• Nancy Ruth Otto, M.D.
• Pamela Otto, M.D.

• All providers in San Antonio, TX
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.