John R Herbolsheimer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1217 Issued in NE

Practice address

3906 Twin Creek Dr
Ste. 102
Bellevue, NE 68123-4104

Phone

(402) 932-8007

Fax

(402) 932-8112

NPI assigned

Sep 16, 2006

Last updated

Oct 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urban Eyes PCGroup PAC ID 9638343650, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Urban Eyes PC

  dba Pearle Vision

  • Optometrist
  • Bellevue, NE
  • NPI 1831478338
  Medicare reassignment Care Compare group NPD Authorized official
• Focused Eye Care PC

  dba pearle vision

  • Optometrist
  • Omaha, NE
  • NPI 1689870248
  Medicare reassignment NPD
• Urban Eyes, PC

  dba Pearle Vision

  • Optometrist
  • La Vista, NE
  • NPI 1518419290
  Authorized official Same address or phone
• Focused Eye Care

  dba pearle vision

  • Durable Medical Equipment & Medical Supplies
  • Omaha, NE
  • NPI 1215010293
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1144326174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 TWIN CREEK DR",
            "address_2": "STE. 102",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681234104",
            "telephone_number": "402-932-8007",
            "fax_number": "402-932-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 TWIN CREEK DR",
            "address_2": "STE. 102",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681234104",
            "telephone_number": "402-932-8007",
            "fax_number": "402-932-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBOLSHEIMER",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026095700",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025340600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Paul Hennen, RPH
• Martha M Henriquez
• Siviah Henry
• Ricky Dean Hensley
• Rylee Ann Henson
• Shelley Marie Herbst, PT
• Melissa Kay Heredia
• Heritage Ridge Operating LLC (Heritage Ridge Retirement Community)
• Laronica Herlm
• Alyssa Herman

• Optometrist in Bellevue, NE
• Providers in Bellevue, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.