Active NPI
Thomas Patrick Patera, O.D.
- Optometrist
- Sioux City, IA
National Provider Identifier
1497837751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 01683
- Practice address
- 5001 Sergeant Rd
Suite 45
Sioux City, IA 51106-4775 - Phone
- (712) 224-4600
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 01683 | IA | Primary |
| Optometrist | 152W00000X | 1017 | NE |
Addresses
Primary practice location
5001 Sergeant Rd
Suite 45
Sioux City, IA 51106-4775
Mailing address
1823 S 194TH Ave
Omaha, NE 68130-3770
Phone (402) 763-9498
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100250180-00 | Medicaid | NE | |
| 3160648 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01683 | IA | MD | Registered Dietitian |
| 1017 | NE | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients | |
| Luxottica Retail North America Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Eyewear Supplier
- Sioux City, IA
- NPI 1336205566
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497837751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1823 S 194TH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681303770",
"telephone_number": "402-763-9498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 SERGEANT RD",
"address_2": "SUITE 45",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511064775",
"telephone_number": "712-224-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATERA",
"first_name": "THOMAS",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "01683",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "1017",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100250180-00",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3160648",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.