Individual provider Active NPI

Jason Stephan, OD

  • Optometrist
  • Lincoln, NE
National Provider Identifier
1073678488
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1175 Issued in NE
Practice address
651 N 66TH St
Suite 100
Lincoln, NE 68505-2478
Phone
(402) 466-1916
Fax
(402) 466-4154
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1175 NE Primary

Addresses

Primary practice location

651 N 66TH St
Suite 100
Lincoln, NE 68505-2478

Mailing address

651 N 66TH St
Suite 100
Lincoln, NE 68505-2478
Phone (402) 466-1916

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
I20040604000699 NE Practitioner - Optometry 5890777619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln Vision Center PCGroup PAC ID 7416002068, 5 clinicians

Practice addresses (Care Compare)

739 W 10TH St a
Wahoo Vision Center
Wahoo, NE 68066-1133
Phone (402) 443-3168

Merit-based Incentive Payment System (MIPS)

Final score
97.3 of 100Reported as group
Quality
94.59
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Vision Center, PC Optometrist CurrentSince Jun 1, 2009 Accepting new patients
Lincoln Vision Center PC Optometrist CurrentSince Aug 2, 2020 Accepting new patients
Lincoln Vision Clinic, P.C. Optometrist Past Accepting new patients

Locations

651 N 66th St
Ste 100
Lincoln, NE 68505
Phone (402) 466-1916

739 W 10th St
Ste A
Wahoo, NE 68066
Phone (402) 443-3168

Interoperability endpoints

  • Direct secure messaging: jason.stephan@direct.revolutionehr.com

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1073678488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 N 66TH ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052478",
            "telephone_number": "402-466-1916",
            "fax_number": "402-466-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 N 66TH ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052478",
            "telephone_number": "402-466-1916",
            "fax_number": "402-466-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "JASON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.