Individual provider Active NPI

Brian David Hansel, O.D.

  • Optometrist
  • Bettendorf, IA
National Provider Identifier
1982833653
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002466 Issued in IA
Practice address
777 Tanglefoot LN
Bettendorf, IA 52722-1650
Phone
(563) 323-2020
Fax
(563) 328-5694
NPI assigned
Jul 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002466 IA Primary
Corneal and Contact Management Optometrist 152WC0802X 002466 IA
Low Vision Rehabilitation Optometrist 152WL0500X 002466 IA
Pediatric Optometrist 152WP0200X 002466 IA
Vision Therapy Optometrist 152WV0400X 002466 IA
Occupational Vision Optometrist 152WX0102X 002466 IA

Addresses

Primary practice location

777 Tanglefoot LN
Bettendorf, IA 52722-1650

Mailing address

777 Tanglefoot LN
Bettendorf, IA 52722-1650
Phone (563) 323-2020

Other identifiers 1

IdentifierTypeStateIssuer
405007MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091001000640 IA Practitioner - Optometry 9638215882 Reassigns benefits to 1 organization
I20150618002824 IL Practitioner - Optometry 9638215882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Surgeons Associates PCGroup PAC ID 4183521206, 19 clinicians

Practice addresses (Care Compare)

4731 45TH St CT
Rock Island, IL 61201-7102
Phone (309) 793-2020

777 Tanglefoot LN
Bettendorf, IA 52722-1650
Phone (563) 323-2020

Merit-based Incentive Payment System (MIPS)

Final score
78.56 of 100Reported as group
Quality
97.61
Promoting interoperability
98
Improvement activities
40
Cost
32.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002466IAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgeons Associates PC Optometrist CurrentSince Jul 1, 2013 Accepting new patients
Eye Surgeons Associates PC Optometrist PastSince Jun 1, 2015 Accepting new patients

Locations

777 Tanglefoot Ln
Bettendorf, IA 52722
Phone (319) 323-8888

422 S State St
Geneseo, IL 61254
Phone (309) 944-4608

2570 24th St
Ste 124
Rock Island, IL 61201
Phone (309) 779-3670

4731 45th Street Ct
Rock Island, IL 61201
Phone (309) 793-2020

Interoperability endpoints

  • Direct secure messaging: brian.hanselod.p1@direct.esaeyecare.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1982833653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 TANGLEFOOT LN",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221650",
            "telephone_number": "563-323-2020",
            "fax_number": "563-328-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 TANGLEFOOT LN",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221650",
            "telephone_number": "563-323-2020",
            "fax_number": "563-328-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEL",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002466",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IA",
            "license": "002466",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "IA",
            "license": "002466",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IA",
            "license": "002466",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IA",
            "license": "002466",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "IA",
            "license": "002466",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405007",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.