Brooke Louise Vetter, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1566 Issued in AZ

Practice address

1990 McCulloch Blvd N Ste 101
Lake Havasu Family Eyecare
Lake Havasu City, AZ 86403-5749

Phone

(928) 855-5026

NPI assigned

Nov 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Illinois College of Optometry at Chicago, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Havasu Family Eyecare LLCGroup PAC ID 0749220051, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.83 of 100Reported as group

Quality

65.65

Improvement activities

40

Procedures performed for Medicare patients

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.

• Lake Havasu Family Eyecare, LLC

  • Optometrist
  • Lake Havasu City, AZ
  • NPI 1457569121
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1982779898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 MCCULLOCH BLVD N STE 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035749",
            "telephone_number": "928-855-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 MCCULLOCH BLVD N STE 101",
            "address_2": "LAKE HAVASU FAMILY EYECARE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035749",
            "telephone_number": "928-855-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTER",
        "first_name": "BROOKE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5394153-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicholas Virden, P.T., DPT
• Vision Care Center

• Optometrist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.