Individual provider Active NPI

Wayne Earle Snyder, M.D.

  • Ophthalmology Physician
  • Watertown, SD
National Provider Identifier
1053474254
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
1496 Issued in SD
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, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1496OtherSDSTATE LICENSE
6300380MedicaidSD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080313000125 SD Practitioner - Ophthalmology 4981789039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1496SDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kunkel-Snyder Optometric, P.C CurrentSince Aug 20, 2007 Accepting new patients
Wayne E Snyder MD, PC Ophthalmology CurrentSince Sep 30, 1985 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.

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

Verify at the official NPI Registry.