Individual provider Active NPI

Jesse Andrew Brewster, OD

  • Optometrist
  • Tomball, TX
National Provider Identifier
1992298939
Registry record updated Jun 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9253TG Issued in TX
Practice address
14223 FM 2920 Rd Ste 100
Tomball, TX 77377-6422
Phone
(281) 205-2290
NPI assigned
Jun 13, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9253TG TX Primary

Addresses

Primary practice location

14223 FM 2920 Rd Ste 100
Tomball, TX 77377-6422

Mailing address

14223 FM 2920 Rd Ste 100
Tomball, TX 77377-6422
Phone (281) 205-2290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180820000988 TX Practitioner - Optometry 0446509798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9253TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tso Richmond Aliana PA Optometrist PastSince Jul 31, 2018 Accepting new patients
National Vision, Inc. Past Accepting new patients

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559952000000",
    "number": "1992298939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14223 FM 2920 RD STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773776422",
            "telephone_number": "281-205-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14223 FM 2920 RD STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773776422",
            "telephone_number": "281-205-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWSTER",
        "first_name": "JESSE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2019-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9253TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

Verify at the official NPI Registry.