Active NPI
Bruce M Siegling, OD
- Optometrist
- Watertown, SD
National Provider Identifier
1487674305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 118
- Practice address
- 1520 4TH St NE
Watertown, SD 57201-6824 - Phone
- (605) 882-1818
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 118 | SD | Primary |
Addresses
Primary practice location
1520 4TH St NE
Watertown, SD 57201-6824
Mailing address
310 8TH Ave NW Ste 503
Aberdeen, SD 57401-2369
Phone (605) 225-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9202017 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118 | SD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196380800000",
"number": "1487674305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 8TH AVE NW STE 503",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574012369",
"telephone_number": "605-225-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 4TH ST NE",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "572016824",
"telephone_number": "605-882-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEGLING",
"first_name": "BRUCE",
"middle_name": "M",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SD",
"license": "118",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9202017",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, SD
- Charles Frederick Sherman, PHD
- Aaron B Shives, MD
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- Shopko Stores Operating Co. LLC (ShopKo Optical 054)
- Shoptikal LLC (Shopko Optical 4054)
- Dawn Renee Sikkink, BA
- Erik Shaun Simon, PA-C
- Lynn Simon, P.T.
- Mikala Simon
- Simplicity Home Care of South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.