Individual provider Active NPI

Jerika Kirwan, O.D.

  • Optometrist
  • Wagner, SD
National Provider Identifier
1174906705
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
719 Issued in SD
Practice address
720 West Hwy 46
Wagner, SD 57380
Phone
(605) 384-3565
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 719 SD Primary

Addresses

Primary practice location

720 West Hwy 46
Wagner, SD 57380

Mailing address

310 8TH Ave NW
Aberdeen, SD 57401-2365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150901000454 SD Practitioner - OptometryPractitioner - Ophthalmology 5193031532 Reassigns benefits to 1 organization
I20201215002006 NE Practitioner - Optometry 5193031532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Care Associates LLPGroup PAC ID 2466433990, 17 clinicians

Practice addresses (Care Compare)

516 W Locust Ave
Plainview, NE 68769-4119
Phone (402) 582-4554

720 W Hwy 46
Wagner, SD 57380-9373
Phone (605) 384-3565

Merit-based Incentive Payment System (MIPS)

Final score
83.73 of 100Reported as group
Quality
85.15
Promoting interoperability
73
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1520NEMDPhysical Therapist
719SDMDSpeech-Language Pathologist

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1174906705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 8TH AVE NW",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574012365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WEST HWY 46",
            "city": "WAGNER",
            "state": "SD",
            "postal_code": "57380",
            "telephone_number": "605-384-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWAN",
        "first_name": "JERIKA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagner, SD

Sources for this page

Verify at the official NPI Registry.