Individual provider Active NPI

Matthew Forest Appenzeller, MD

  • Ophthalmology Physician
  • Omaha, NE
National Provider Identifier
1235340522
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
28330 Issued in NE
Practice address
4353 Dodge St
Omaha, NE 68131-2709
Phone
(402) 552-2020
Fax
(402) 552-2367
NPI assigned
May 25, 2007
Last updated
Apr 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 42480 IA
Retina Specialist (Ophthalmology) Physician 207WX0107X 28330 NE
Ophthalmology Physician 207W00000X 28330 NE Primary

Addresses

Primary practice location

4353 Dodge St
Omaha, NE 68131-2709

Mailing address

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150420000729 NE Practitioner - Ophthalmology 9931279387 Reassigns benefits to 2 organizations
I20150507000150 IA Practitioner - Ophthalmology 9931279387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical University of South Carolina College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians
Midwest Eye Care PCGroup PAC ID 8628960572, 24 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone (712) 396-4000

1001 Risen Son Blvd
Council Bluffs, IA 51503-1910
Phone (712) 256-8600

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

320 Ebaugh St
Methodist Physicians Clinic Glenwood
Glenwood, IA 51534-1811
Phone (712) 527-5204

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

715 Harmony St
Suite 300
Council Bluffs, IA 51503-3147
Phone (402) 552-2020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28330NEMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Care PC CurrentSince Apr 6, 2015 Accepting new patients
Midwest Eye Care, PC Ophthalmology CurrentSince Apr 6, 2015 Accepting new patients
Physicians Clinic Inc CurrentSince Feb 1, 2018 Accepting new patients
Midwest Eye Care, PC Ophthalmology Past Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

201 Ridge St
Ste 312
Council Bluffs, IA 51503
Phone (402) 815-1970

715 Harmony St
Ste 300
Council Bluffs, IA 51503
Phone (712) 388-2600

320 Ebaugh St
Glenwood, IA 51534
Phone (712) 527-3125

2301 Eastern Ave
Red Oak, IA 51566
Phone (712) 623-7270

11946 Standing Stone Dr
Gretna, NE 68028
Phone (402) 815-4500

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

13500 California St
Omaha, NE 68154

16120 W Dodge Rd
Omaha, NE 68118
Phone (402) 354-0550

17675 Welch Plz
Omaha, NE 68135
Phone (402) 354-7600

4353 Dodge St
Omaha, NE 68131
Phone (402) 502-5599

8901 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-8990

101 E Centennial Rd
Papillion, NE 68046
Phone (402) 354-7750

625 S Pine St
Valley, NE 68064
Phone (402) 359-2277

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1235340522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020",
            "fax_number": "402-552-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020",
            "fax_number": "402-552-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPENZELLER",
        "first_name": "MATTHEW",
        "middle_name": "FOREST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "42480",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NE",
            "license": "28330",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NE",
            "license": "28330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.