Cal Edward Wiese, OD
Individual provider Active NPI Optometrist · Sioux City, IA
NPI 1356072508 · NPPES record last updated Jun 23, 2022
Key facts
- NPI
- 1356072508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 114761 (IA)
- Practice address
- 1909 Hamilton Blvd
Sioux City, IA 51104-4148 - Phone
- (712) 252-4333
- NPI assigned
- Jun 20, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sahni OD LLC
Aria Vision Care, LLC
Alphapointe
Practice addresses (Care Compare)
10875 Grandview Dr
Overland Park, KS 66210-1571
Phone (913) 469-8686
2847 S Ingram Mill Rd
Suite A100
Springfield, MO 65804-4006
Phone (888) 840-3032
7501 Prospect Ave
Kansas City, MO 64132-2103
Phone (816) 237-2047
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230410000411 | MO | Practitioner - Optometry | 4183008501 | Reassigns benefits to 3 organizations |
| I20230410000536 | KS | Practitioner - Optometry | 4183008501 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2180 | KS | MD | Clinical Psychologist |
| 114761 | IA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aria Vision Care, LLC | Optometrist | Current |
Accepting new patients |
| Sahni OD LLC | Optometrist | Current |
Accepting new patients |
| Vision Care Clinic PC | Optometrist | Past | Accepting new patients |
| Vision Care Clinic PC | Optometrist | Past | Accepting new patients |
Locations
8500 W 110th St
Ste 450
Overland Park, KS 66210
Phone (913) 362-1112
10875 Grandview Dr
Ste 2260
Overland Park, KS 66210
Phone (816) 237-2020
112 SW 7th St
Ste 3C
Topeka, KS 66603
Phone (347) 510-6956
2847 S Ingram Mill Rd
Ste A100
Springfield, MO 65804
Phone (214) 705-2301
Interoperability endpoints
- cal.wiese@direct.revolutionehr.com
- cal.wiese.1@32152.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 114761 | IA | Yes |
Addresses
Primary practice location
1909 Hamilton Blvd
Sioux City, IA 51104-4148
Mailing address
201 N Main St
Denison, IA 51442-1373
Phone (712) 263-2020
Other practice location 1
721 10th St
Onawa, IA 51040-1128
Phone (712) 433-2020
Other practice location 2
201 N Main St
Denison, IA 51442-1373
Phone (712) 263-2020
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Cal.Wiese@direct.revolutionehr.com | Direct |
Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.