Active NPI
Wayne Earle Snyder, M.D.
- Ophthalmology Physician
- Watertown, SD
National Provider Identifier
1053474254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 1496
- Practice address
- 1225 4TH St NE
Watertown, SD 57201-1204 - Phone
- (605) 882-4175
- Fax
- (605) 882-2962
- NPI assigned
- Dec 18, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 1496 | SD | Primary |
Addresses
Primary practice location
1225 4TH St NE
Watertown, SD 57201-1204
Mailing address
1225 4TH St NE
Watertown, SD 57201-1204
Phone (605) 882-4175
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1496 | Other | SD | STATE LICENSE |
| 6300380 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080313000125 | SD | Practitioner - Ophthalmology | 4981789039 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1496 | SD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kunkel-Snyder Optometric, P.C | Current | Accepting new patients | |
| Wayne E Snyder MD, PC | Ophthalmology | Current | Accepting new patients |
Locations
1225 4th St NE
Watertown, SD 57201
Phone (605) 882-4174
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Watertown, SD
- NPI 1376733949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053474254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 4TH ST NE",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "572011204",
"telephone_number": "605-882-4175",
"fax_number": "605-882-2962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 4TH ST NE",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "572011204",
"telephone_number": "605-882-4175",
"fax_number": "605-882-2962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "WAYNE",
"middle_name": "EARLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SD",
"license": "1496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1496",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6300380",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.