MK Optical Enterprises, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1257 Issued in NE

Legal business name

MK OPTICAL ENTERPRISES, INC.

Doing business as

The Spectacle Place

Practice address

201 Capitol Beach Blvd
Ste 11
Lincoln, NE 68528-1600

Phone

(402) 475-3937

Fax

(402) 475-4715

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Wade Dinslage, O.D.

Title

President

Phone

(402) 475-3937

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• The Spectacle Place Doing business as

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Lynn Brammeier, OD

  • Optometrist
  • Omaha, NE
  • NPI 1003923855
  NPD (past)
• Kevin M Hobbs, O.D.

  • Optometrist
  • Columbus, NE
  • NPI 1750377354
  NPD (past)
• Jonathan Glyndon Knutson, OD

  • Optometrist
  • Lincoln, NE
  • NPI 1003800012
  NPD (past)
• Steven P Sandman, O.D.

  • Optometrist
  • Beatrice, NE
  • NPI 1316967516
  NPD (past)
• Jay Robert Trofholz, O.D.

  • Optometrist
  • Columbus, NE
  • NPI 1881680486
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1043491418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CAPITOL BEACH BLVD",
            "address_2": "STE 11",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685281600",
            "telephone_number": "402-475-3937",
            "fax_number": "402-475-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CAPITOL BEACH BLVD",
            "address_2": "STE 11",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685281600",
            "telephone_number": "402-475-3937",
            "fax_number": "402-475-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK OPTICAL ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "DINSLAGE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-475-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025560100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025562700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD OF NEBRASKA",
            "identifier": "37187",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Spectacle Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Glee Mize, PHD
• Jenise Ann Mizell
• Sierra Rae Mizell
• MJ Schmid, PC
• MK Optical Enterprises, Inc (The Spectacle Place)
• Edward Joseph Mlinek, MD
• MLS Physical Therapy, LLC
• Christopher Moak
• Olivia Moats
• Mobile Mom Physical Therapy, LLC

• Optometrist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.