Jacob Michael Diedrich, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

758 Issued in SD

Practice address

5001 Sergeant Rd Ste 45
Sioux City, IA 51106-4777

Phone

(712) 224-4600

NPI assigned

Jun 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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

Specialty

Optometry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Guys PLLCGroup PAC ID 9739625815, 3 clinicians

Howlin Vision Clinic PCGroup PAC ID 6901893783, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.17 of 100Reported as group

Quality

98.33

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Guys PLLC

  dba North Central Eye

  • Optometrist
  • Sioux Falls, SD
  • NPI 1104666502
  Medicare reassignment Care Compare group NPD
• Howlin Vision Clinic, P.C.

  dba Eye-Site

  • Optometrist
  • Sioux Falls, SD
  • NPI 1083777676
  Medicare reassignment Care Compare group NPD
• Eyecare Specialties of South Dakota, P.C.

  • Optometrist
  • Sioux Falls, SD
  • NPI 1942176680
  Medicare reassignment NPD
• Howlin Vision Clinic, P.C.

  dba Optics

  • Optometrist
  • Sioux Falls, SD
  • NPI 1538340575
  NPD
• Howlin Vision Clinic, P.C.

  dba Eye-Site

  • Optometrist
  • Sioux Falls, SD
  • NPI 1902533276
  NPD
• Barnett Vision Clinic LLC

  • Optometrist
  • Sioux Falls, SD
  • NPI 1285274332
  NPD (past)

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1407415599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7507 S BEAL AVE APT 13",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571084918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 SERGEANT RD STE 45",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064777",
            "telephone_number": "712-224-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5129 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571082670",
            "country_code": "US",
            "telephone_number": "605-332-2231",
            "fax_number": "605-330-9519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEDRICH",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "758",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "096566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Devries
• Kimberly Joan Devries, LISW
• Hannah Irene Dewald, M.D.
• Brenda Dick, DDS
• Cassandra Dickerson
• Christopher S Diehl, O.D.
• Nancy Lou Dierenfield, D.C.
• Thomas B Dodds
• Richard J Dohrmann, DDS MS
• Jessica Dawn Dominowski

• Optometrist in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.