Active NPI
Richard B Hetrick, OD
- Optometrist
- Erie, PA
National Provider Identifier
1942274691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG001090
- Practice address
- 1801 W 8TH St
Erie, PA 16505-4938 - Phone
- (814) 455-8004
- Fax
- (814) 456-6054
- NPI assigned
- Feb 16, 2006
- Last updated
- Aug 31, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG001090 | PA | Primary |
Addresses
Primary practice location
1801 W 8TH St
Erie, PA 16505-4938
Mailing address
1801 W 8TH St
Erie, PA 16505-4938
Phone (814) 455-8004
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1801 W 8TH St
Erie, PA 16505-4938
Phone (814) 455-8004
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG001090 | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary T Brotherson MD Inc | Current | Accepting new patients | |
| Gary T Brotherson MD Inc | Optometrist | Current | Accepting new patients |
Locations
1801 W 8th St
Erie, PA 16505
Phone (814) 455-8004
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": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1942274691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 W 8TH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165054938",
"telephone_number": "814-455-8004",
"fax_number": "814-456-6054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W 8TH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165054938",
"telephone_number": "814-455-8004",
"fax_number": "814-456-6054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETRICK",
"first_name": "RICHARD",
"middle_name": "B",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.