Active NPI
Jonathan Glyndon Knutson, OD
- Optometrist
- Lincoln, NE
National Provider Identifier
1003800012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1147
- Practice address
- 5630 S 84TH St
Suite 120
Lincoln, NE 68516-4427 - Phone
- (402) 488-2211
- NPI assigned
- Sep 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1147 | NE | Primary |
Addresses
Primary practice location
5630 S 84TH St
Suite 120
Lincoln, NE 68516-4427
Mailing address
5630 S 84TH St
Suite 120
Lincoln, NE 68516-4427
Phone (402) 488-2211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36755 | Other | NE | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5630 S 84TH St
Suite 120
Lincoln, NE 68516-4470
Phone (402) 488-2211
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 49 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1147 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signature Eye Care, P.C. | Optometrist | Current | Accepting new patients |
| Vision Associates Inc | Optometrist | Past | Accepting new patients |
| MK Optical Enterprises, Inc. | Optometrist | Past | Accepting new patients |
| Posner Enterprises, Inc. | Optometrist | Past | Accepting new patients |
| Vision Assoicates Inc | Optometrist | Past | Accepting new patients |
| MK Optical Enterprises, Inc | Optometrist | Past | Accepting new patients |
| Mid-Plains Eyecare Center PC | Optometrist | Past | Accepting new patients |
Locations
5630 S 84th St
Ste 120
Lincoln, NE 68516
Phone (402) 488-2211
Organizations & group practices 7
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.
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- Optometrist
- Lincoln, NE
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- Syracuse, NE
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1003800012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5630 S 84TH ST",
"address_2": "SUITE 120",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164427",
"telephone_number": "402-488-2211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5630 S 84TH ST",
"address_2": "SUITE 120",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164427",
"telephone_number": "402-488-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTSON",
"first_name": "JONATHAN",
"middle_name": "GLYNDON",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-06",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "1147",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "36755",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.