Individual provider Active NPI

Joel Robert Holmquist, OD

  • Optometrist
  • Fremont, NE
National Provider Identifier
1013691484
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1615 Issued in NE
Practice address
3351 E 24TH St
Fremont, NE 68025-2446
Phone
(402) 704-6964
NPI assigned
Jun 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1615 NE Primary

Addresses

Primary practice location

3351 E 24TH St
Fremont, NE 68025-2446

Mailing address

16861 Browne St
Omaha, NE 68116-3202
Phone (308) 214-1215

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230620002659 NE Practitioner - Optometry 0840658019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Moderneyes Eyecare and Eyewear, PCGroup PAC ID 2961785944, 3 clinicians

Practice addresses (Care Compare)

19060 Q St
Suite 107
Omaha, NE 68135-1504
Phone (402) 807-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1615NEMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Moderneyes Eyecare & Eyewear, PC Optometrist CurrentSince Jul 15, 2024 Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients

Locations

19060 Q St
Ste 107
Omaha, NE 68135
Phone (402) 616-6319

3044 S 84th St
Ste 1
Omaha, NE 68124
Phone (402) 391-1143

Networks

  • IA HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO
  • IA HMO C-SNP
  • CO HMO D-SNP

Organizations & group practices 5

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1013691484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16861 BROWNE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681163202",
            "telephone_number": "308-214-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 E 24TH ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252446",
            "telephone_number": "402-704-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMQUIST",
        "first_name": "JOEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.