Individual provider Active NPI

Jarrett Craig Lieder, OD

  • Optometrist
  • Oshkosh, WI
National Provider Identifier
1104745256
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4157-35 Issued in WI
Practice address
2510 W 9TH Ave
Oshkosh, WI 54904-8125
Phone
(920) 426-2020
NPI assigned
Jul 13, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4157-35 WI Primary

Addresses

Primary practice location

2510 W 9TH Ave
Oshkosh, WI 54904-8125

Mailing address

2510 W 9TH Ave
Oshkosh, WI 54904-8125
Phone (920) 426-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2510 W 9TH Ave
Oshkosh, WI 54904-8125

3369 Jones CT
Oshkosh, WI 54904-8857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr J J Marsh LTD Optometrist CurrentSince Jul 23, 2026 Accepting new patients

Locations

2510 W 9th Ave
Oshkosh, WI 54904
Phone (920) 426-2020

908 E Main St
Ste A
Winneconne, WI 54986
Phone (920) 528-4477

Organizations & group practices 1

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": "1783900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104745256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W 9TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048125",
            "telephone_number": "920-426-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W 9TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048125",
            "telephone_number": "920-426-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDER",
        "first_name": "JARRETT",
        "middle_name": "CRAIG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4157-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.