Individual provider Active NPI

Matthew D. Georgeson, O.D.

  • Optometrist
  • River Falls, WI
National Provider Identifier
1467552299
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3954-35 Issued in WI
Practice address
183 E Pomeroy St
River Falls, WI 54022-3506
Phone
(715) 425-0115
Fax
(715) 425-6001
NPI assigned
Sep 22, 2006
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3954-35 WI Primary

Addresses

Primary practice location

183 E Pomeroy St
River Falls, WI 54022-3506

Mailing address

183 E Pomeroy St
River Falls, WI 54022-3506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, WA, ID3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240503002062 WI Practitioner - Optometry 9931169398
I20250130002156 WA Practitioner - Optometry 9931169398 Reassigns benefits to 1 organization
I20250923002054 ID Practitioner - Optometry 9931169398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobilitycares LLCGroup PAC ID 3476880071, 2 clinicians
Mobilitycares Washington LLCGroup PAC ID 5597118216, 4 clinicians

Practice addresses (Care Compare)

108 E Owyhee Ave
Homedale, ID 83628-3227
Phone (208) 337-3168

2004 N 22ND Ave
Pasco, WA 99301-3313
Phone (208) 995-1122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3954-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilitycares Washington LLC Optometrist CurrentSince Dec 27, 2024 Accepting new patients
Mobilitycares LLC Optometrist CurrentSince Aug 8, 2025 Accepting new patients
Mobilitycares Utah LLC Optometrist PastSince Apr 26, 2020 Accepting new patients

Locations

108 E Owyhee Ave
Homedale, ID 83628

108 E Owyhee Ave
Homedale, ID 83628
Phone (208) 337-3168

1351 W Pine Ave
Meridian, ID 83642
Phone (208) 467-7298

2004 N 22nd Ave
Pasco, WA 99301
Phone (208) 995-1122

Interoperability endpoints

  • Direct secure messaging: mgeorgeson@rfeye.intellechartdirect.net

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1467552299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 E POMEROY ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540223506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 E POMEROY ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540223506",
            "telephone_number": "715-425-0115",
            "fax_number": "715-425-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGESON",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3954-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Falls, WI

Sources for this page

Verify at the official NPI Registry.