Randy L Hertneky, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1092 Issued in CO

Practice address

415 Main St
Wray, CO 80758-1724

Phone

(970) 332-4823

Fax

(970) 848-5346

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: randy.hertneky1@direct.revolutionehr.com

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.

• Morrison Optometric Associates PA

  • Optometrist
  • Burlington, CO
  • NPI 1609843390

  CO, Optometrist

  Medicare reassignment NPD
• Morrison Optometric Associates PA

  • Optometrist
  • Wray, CO
  • NPI 1992318083
  NPD

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1962489351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581724",
            "telephone_number": "970-332-4823",
            "fax_number": "970-848-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581724",
            "telephone_number": "970-332-4823",
            "fax_number": "970-848-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTNEKY",
        "first_name": "RANDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08010928",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael R Hajek, MD
• Heather Hasenauer, RN
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• Healthone Heart Care LLC
• Trudy Herman
• Beth A Kapadia, MD
• Stephanie Kettelson, DPT
• Nicole Dawn Kinen
• Susan R. Krautkramer, P.A.-C
• Kristine E Laible, CNA

• All providers in Wray, CO
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.