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Deactivated NPI 1760486500 Deactivated / Inactive NPI Male Practitioner

Dr. Jack L Hostetler , OD

Optometrist • Gilbert, AZ

✓ Accepts Medicare Assignment
⚠️

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.

Registration / Start Date June 09, 2005
NPI Deactivation Date March 21, 2006
Total Practice Duration ~26 Years of Practice (1980 – 2006)

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

Practice Address

2680 S Val Vista Dr
#111

Gilbert, AZ 852952152

Telephone 4808070288
Fax 4802997199
Associated Practice Facility / Clinic
🏢 Desert Valley Ent, Pc Facility NPI 1184713430

Medicare Profile & Education

Medical School

Southern College Of Optometry

Graduation Year

1980

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Gilbert, AZ

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
46 Yrs +25.1 yrs vs City Avg
City Avg: 20.9 Yrs
State Avg: 20.2 Yrs
Regional Practice Density
48 Specialists

Practicing in Gilbert, AZ (1373 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
19.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Hostetler (46 Years) 46 Yrs
Gilbert Specialty Average (20.9 Years) 20.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
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

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License AZ 349

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

Medicaid State Provider ID
860439395 (AZ)

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

1 Associated Practitioners
NPI 1023092228

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location June 25, 2008

Registered at 2680 S VAL VISTA DR, #111, GILBERT, AZ 852952152 (Tel: 4808070288)

📍
Updated Business Mailing Address June 25, 2008

Registered at 2680 S VAL VISTA DR, #111, GILBERT, AZ 852952152 (Tel: 4808070288)

👤
Provider Name / Credentials Updated June 25, 2008

Recorded as JACK HOSTETLER, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2008

Optometrist (License #349 in AZ)

🔄
NPI Profile Reactivated March 29, 2006

Record officially reactivated for active practice on March 29, 2006

⚠️
NPI Profile Deactivated March 21, 2006

Record deactivated on March 21, 2006

🟢
Initial NPI Registration & Enumeration June 09, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760486500
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 09, 2005
Last Update: June 25, 2008
Deactivation Date: March 21, 2006
Sole Proprietor: No

Mailing Address

2680 S Val Vista Dr, #111

Gilbert, AZ 852952152

Phone: 4808070288

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.