Individual provider Active NPI

Jeremiah D Baumfalk, O.D.

  • Optometrist
  • Lincoln, NE
National Provider Identifier
1497749204
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1214 Issued in NE
Practice address
651 N 66TH St
Suite 300
Lincoln, NE 68505-2478
Phone
(402) 464-3156
Fax
(402) 464-1214
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1214 NE Primary

Addresses

Primary practice location

651 N 66TH St
Suite 300
Lincoln, NE 68505-2478

Mailing address

651 N 66TH St
Suite 300
Lincoln, NE 68505-2478
Phone (402) 464-3156

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040728000887 NE Practitioner - Optometry 3870492523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln Vision Center PCGroup PAC ID 7416002068, 5 clinicians

Practice addresses (Care Compare)

739 W 10TH St a
Wahoo Vision Center
Wahoo, NE 68066-1133
Phone (402) 443-3168

Merit-based Incentive Payment System (MIPS)

Final score
97.3 of 100Reported as group
Quality
94.59
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
391NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Vision Center, PC Optometrist CurrentSince Jun 1, 2016 Accepting new patients
Hastings Optometric Associates LLC Optometrist Current Accepting new patients
Nova Southeastern University, Inc PastSince Jan 1, 1990 Accepting new patients

Locations

651 N 66th St
Ste 100
Lincoln, NE 68505
Phone (402) 466-1916

739 W 10th St
Ste A
Wahoo, NE 68066
Phone (402) 443-3168

Interoperability endpoints

  • Direct secure messaging: jeremiah.baumfalk@direct.revolutionehr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1497749204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 N 66TH ST",
            "address_2": "SUITE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052478",
            "telephone_number": "402-464-3156",
            "fax_number": "402-464-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 N 66TH ST",
            "address_2": "SUITE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052478",
            "telephone_number": "402-464-3156",
            "fax_number": "402-464-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMFALK",
        "first_name": "JEREMIAH",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.