Individual provider Active NPI

Matthew E Johnson, OD

  • Optometrist
  • Lincoln, NE
National Provider Identifier
1255483103
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1150-323 Issued in NE
Practice address
8250 Old Cheney Rd Ste a
Lincoln, NE 68516-3533
Phone
(402) 817-5626
Fax
(402) 817-5631
NPI assigned
Jan 18, 2007
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1150 NE
Optometrist 152W00000X 1150-323 NE Primary

Addresses

Primary practice location

8250 Old Cheney Rd Ste a
Lincoln, NE 68516-3533

Mailing address

8250 Old Cheney Rd Ste a
Lincoln, NE 68516-3533
Phone (402) 817-5626

Other identifiers 1

IdentifierTypeStateIssuer
36321OtherNEBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071205000677 NE Practitioner - Optometry 6204925761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proeye Group Gateway, P.C.Group PAC ID 5597854174, 2 clinicians

Practice addresses (Care Compare)

8250 Old Cheney Rd
Lincoln, NE 68516-3532
Phone (402) 817-5626

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1150-323NEMDOptometrist
1150NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Eyecare Gateway Inc. Optometrist Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1255483103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8250 OLD CHENEY RD STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163533",
            "telephone_number": "402-817-5626",
            "fax_number": "402-817-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8250 OLD CHENEY RD STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163533",
            "telephone_number": "402-817-5626",
            "fax_number": "402-817-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1150",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1150-323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36321",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.