Optical Gallery, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

OPTICAL GALLERY, LLC

Practice address

3923 S 48TH St
Lincoln, NE 68506-4318

Phone

(402) 488-3106

Fax

(402) 488-3329

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Michael J Thilges

Title

Partowner/Manager

Phone

(402) 488-3106

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• OPTICAL GALLERY Other name

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Ann Raymond, O.D.

  • Optometrist
  • Lincoln, NE
  • NPI 1760501456
  Medicare reassignment Care Compare group NPD
• Ashley Nicole Wilcox, O.D.

  • Optometrist
  • Lincoln, NE
  • NPI 1023273018
  Medicare reassignment Care Compare group NPD
• Carla Jane Ericksen, O.D.

  • Optometrist
  • Lincoln, NE
  • NPI 1851434153
  Medicare reassignment NPD
• Charles H Coren, OD

  • Optometrist
  • Lincoln, NE
  • NPI 1316095094
  NPD (past)
• Jesse A Yager, O.D.

  • Optometrist
  • Lincoln, NE
  • NPI 1790779502
  NPD (past)
• Trevor Lee Klein, O.D.

  • Optometrist
  • Spartanburg, SC
  • NPI 1528148830
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1306019062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3923 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064318",
            "telephone_number": "402-488-3106",
            "fax_number": "402-488-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3923 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064318",
            "telephone_number": "402-488-3106",
            "fax_number": "402-488-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL GALLERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "THILGES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTOWNER/MANAGER",
        "authorized_official_telephone_number": "402-488-3106"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "DN6715",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025614200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPTICAL GALLERY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Open MRI of Lincoln, LLC
• Faith Openy
• Damon Opp, O.T.
• Mary Opp, RN
• Optical Gallery LLC
• Optimal Dental, P.C.
• Optimal Eye Care
• Option Care Enterprises, Inc.
• Option Care Enterprises, Inc.
• Oral Pathology Laboratory

• Eyewear Supplier in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Eyewear Supplier in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.