Dr. Jack L Hostetler , OD
Optometrist • Gilbert, AZ
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jack Hostetler has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Jack Hostetler, OD was a registered Optometrist in Gilbert, AZ. Prior to record deactivation on 2006-03-21, Dr. Hostetler completed approximately 26 years of clinical practice following graduation from Southern College Of Optometry in 1980.
Dr. Hostetler was affiliated with San Tan Eyecare Plc and accepted Medicare assignment.
Historical Medicare Part B clinical services included established patient complete exam of visual system, established patient outpatient office visit, photography of the retina. Public procedure reimbursement records and service volume details are provided below for historical transparency.
Practice Location & Contact Primary Location
2680 S Val Vista Dr
#111
Gilbert, AZ 852952152
Medicare Profile & Education
Southern College Of Optometry
1980
✓ Accepts Assignment
In-Person Only
Specialty Benchmarks & Practice Insights
Comparative analytics for Optometrist in Gilbert, AZ
Practicing in Gilbert, AZ (1373 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Clinical Seniority & Experience Comparison
Performed Procedures & Service Volume
Top Medicare Part B procedures performed by this practitioner
| HCPCS Code & Description | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
|
92014
Established patient complete exam of visual system
|
94 | 93 | $128.00 | $121.18 |
|
99212
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
|
32 | 25 | $66.00 | $54.50 |
|
92250
Photography of the retina
|
15 | 15 | $67.80 | $35.66 |
Medical Specialties & State Licenses
NUCC Taxonomy Code: 152W00000X
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Additional State Medicaid & Healthcare Payer Identifiers
Hospital & Practice Group Affiliations
San Tan Eyecare Plc
2680 S Val Vista Dr, Gilbert, AZ 852951606
Phone: 4808070288
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Optometrist
Doctor of Optometry
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Registered at 2680 S VAL VISTA DR, #111, GILBERT, AZ 852952152 (Tel: 4808070288)
Registered at 2680 S VAL VISTA DR, #111, GILBERT, AZ 852952152 (Tel: 4808070288)
Recorded as JACK HOSTETLER, O.D.
Optometrist (License #349 in AZ)
Record officially reactivated for active practice on March 29, 2006
Record deactivated on March 21, 2006
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
2680 S Val Vista Dr, #111
Gilbert, AZ 852952152
Phone: 4808070288
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