Individual provider Active NPI

Brian Peter Haag, O.D.

  • Optometrist
  • Des Moines, IA
National Provider Identifier
1992853139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
IA1951 Issued in IA
Practice address
2405 Ingersoll Ave
Des Moines, IA 50312-5233
Phone
(515) 244-2338
NPI assigned
Jan 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IA1951 IA Primary

Addresses

Primary practice location

2405 Ingersoll Ave
Des Moines, IA 50312-5233

Mailing address

7210 Monroe CT
Urbandale, IA 50322-3120
Phone (515) 270-0595

Other identifiers 1

IdentifierTypeStateIssuer
0077198MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20041116001110 IA Practitioner - Optometry 2466416763 Practice locations: Des Moines, IA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2405 Ingersoll Ave
Des Moines, IA 50312-5233
Phone (515) 244-2338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IA1951IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Real Optics Inc Past Accepting new patients

Organizations & group practices 1

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": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992853139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 MONROE CT",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223120",
            "telephone_number": "515-270-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125233",
            "telephone_number": "515-244-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAG",
        "first_name": "BRIAN",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "IA1951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077198",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.