Individual provider Active NPI

Emily Meihak Stickelberger, O.D.

  • Optometrist
  • Casper, WY
National Provider Identifier
1063662344
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
406T Issued in WY
Practice address
204 S Durbin St
Casper, WY 82601-2562
Phone
(307) 235-2020
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2668 CO
Optometrist 152W00000X 406T WY Primary

Addresses

Primary practice location

204 S Durbin St
Casper, WY 82601-2562

Mailing address

1328 E 12TH St
Casper, WY 82601-3912
Phone (307) 259-7523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20160108001373 WY Practitioner - Optometry 6800946260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Vision and Contact Lens Clinic LLCGroup PAC ID 8224049648, 3 clinicians

Practice addresses (Care Compare)

1328 E 12TH St
Casper, WY 82601-3912
Phone (307) 237-8713

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1651AZMDClinical Psychologist
2668COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision and Contact Lens Clinic, LLC Optometrist CurrentSince Jul 1, 2021 Accepting new patients
Visionworks Inc Past Accepting new patients
Tom Sowash OD & Associates PC Optometrist Past Accepting new patients

Locations

204 S Durbin St
Casper, WY 82601
Phone (307) 234-4585

1328 E 12th St
Casper, WY 82601
Phone (307) 237-8713

Organizations & group practices 3

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": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1063662344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 E 12TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826013912",
            "telephone_number": "307-259-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S DURBIN ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012562",
            "telephone_number": "307-235-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKELBERGER",
        "first_name": "EMILY",
        "middle_name": "MEIHAK",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2668",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "406T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.