Organization Active NPI

Kyle Niemann, O.D., P.C.

  • Optometrist
  • Omaha, NE
National Provider Identifier
1457068173
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KYLE NIEMANN, O.D., P.C.
Doing business as
Visual Eyes Optical
Practice address
1104 S 76TH Ave
Omaha, NE 68124-1559
Phone
(402) 955-2020
NPI assigned
Nov 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Kyle Niemann, ODNPI 1083334106
Title
Owner
Phone
(402) 955-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X

Addresses

Primary practice location

1104 S 76TH Ave
Omaha, NE 68124-1559

Mailing address

1104 S 76TH Ave
Omaha, NE 68124-1559
Phone (402) 955-2020

Other names 1

  • Visual Eyes Optical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221129001145 NE Part B Supplier - Clinic/Group Practice 6305214172 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2312715Visual Eyes Optical1104 S 76TH Ave, Omaha, NE 68124Certificate of waiverOct 16, 2026

National Provider Directory

National Provider Directory

Locations

1104 S 76th Ave
Omaha, NE 68124
Phone (402) 933-7944

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1457068173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 S 76TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241559",
            "telephone_number": "402-955-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 S 76TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241559",
            "telephone_number": "402-955-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE NIEMANN, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "NIEMANN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-955-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visual Eyes Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Visual Eyes Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.