Mark R Winckler, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1269 Issued in NE

Practice address

207 E Main St Ste 1
Pine Ridge, SD 57770-3184

Phone

(605) 867-2772

NPI assigned

Sep 21, 2006

Last updated

Jan 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NE, SD2 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 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Winckler Vision Center, Inc.

  • Optometrist
  • Pine Ridge, SD
  • NPI 1134142243
  Medicare reassignment NPD Authorized official
• Chadron Vision Center, Inc.

  • Optometrist
  • Chadron, NE
  • NPI 1245226984
  Medicare reassignment NPD
• Chadron Vision Center, Inc.

  • Optometrist
  • Gordon, NE
  • NPI 1972533354
  NPD

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1538268388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577700399",
            "telephone_number": "605-867-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E MAIN ST STE 1",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577703184",
            "telephone_number": "605-867-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINCKLER",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "631",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203680",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "4993077",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00390774",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203683",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "09902",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203682",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Jean Wallace
• S Patrick Weber, M.D.
• Lea A Wells, PHARM D
• Evelyn J Weston, RN
• Winckler Vision Center, Inc.
• Shannon Wolfinbarger, CNM
• Dawn Faye Yankton

• Optometrist in Pine Ridge, SD
• Providers in Pine Ridge, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.
• 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.