Individual provider Active NPI

Bernard John Hale, O. D.

  • Optometrist
  • Pinole, CA
National Provider Identifier
1972624658
Registry record updated Jul 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11052T Issued in CA
Practice address
1773 San Pablo Ave
Suite #A1
Pinole, CA 94564-2013
Phone
(510) 724-6520
Fax
(510) 724-7094
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11052T CA Primary

Addresses

Primary practice location

1773 San Pablo Ave
Suite #A1
Pinole, CA 94564-2013

Mailing address

1972 Rosecrest Dr
Oakland, CA 94602-2039
Phone (510) 206-2376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081126000050 CA Practitioner - Optometry 9436219110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orinda Optometry Group, Inc.Group PAC ID 5799726568, 4 clinicians

Practice addresses (Care Compare)

20 Orinda Way
Orinda, CA 94563-2519
Phone (925) 253-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11052TCAMDOptometrist
11052CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tanya N Gill Optometric, Inc. Optometrist PastSince Nov 1, 2007 Accepting new patients
Oakland Vision Center Optometrist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1972624658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1972 ROSECREST DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946022039",
            "telephone_number": "510-206-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1773 SAN PABLO AVE",
            "address_2": "SUITE #A1",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642013",
            "telephone_number": "510-724-6520",
            "fax_number": "510-724-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "BERNARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11052T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.