Chad T Premer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1692 Issued in KS

Practice address

2601 10TH St
Great Bend, KS 67530-4253

Phone

(620) 792-2020

Fax

(620) 792-2583

NPI assigned

Jan 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McCaulley Optometric PAGroup PAC ID 9638134315, 4 clinicians

The Russell Eyecare CenterGroup PAC ID 9133495047, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chad.premer@khindirect.org

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.

• The Russell Eyecare Center

  • Optometrist
  • Russell, KS
  • NPI 1841710563
  Medicare reassignment Care Compare group NPD Authorized official
• McCaulley Optometric PA

  • Optometrist
  • Great Bend, KS
  • NPI 1043255243
  Medicare reassignment Care Compare group NPD
• Doerksen & Associates Inc

  • Optometrist
  • Wichita, KS
  • NPI 1821118415
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1104897677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 10TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675304253",
            "telephone_number": "620-792-2020",
            "fax_number": "620-792-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 10TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675304253",
            "telephone_number": "620-792-2020",
            "fax_number": "620-792-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMER",
        "first_name": "CHAD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200271240A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMENTTO GBA RR MEDICARE",
            "identifier": "P00189553",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gordon F Pfannenstiel, LPC
• Vivian J Pfister, LSCSW
• Jonathan Pike, M.D.
• Jessica A Poe, PTA
• Prairie Dental Associates
• Premier OB-GYN LLC
• Jessica Shea Pries, MD
• Jean Pringle, M.D.
• Sherry K Pruter, LPC
• Daniel Quillin

• Optometrist in Great Bend, KS
• Providers in Great Bend, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.