Individual provider Active NPI

Paul J Sietmann, O.D.

  • Optometrist
  • Frisco, TX
National Provider Identifier
1558356162
Registry record updated Jan 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3849TG Issued in TX
Practice address
10363 Ferry Farm LN
Frisco, TX 75035-6955
Phone
(214) 886-8013
NPI assigned
Sep 20, 2005
Last updated
Jan 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3849TG TX Primary

Addresses

Primary practice location

10363 Ferry Farm LN
Frisco, TX 75035-6955

Mailing address

10363 Ferry Farm LN
Frisco, TX 75035-6955
Phone (214) 886-8013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040616000961 TX Practitioner - Optometry 6002890050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JW Eye Associates, PLLCGroup PAC ID 6305828567, 35 clinicians

Practice addresses (Care Compare)

2380 S Goliad St
Suite 100 Key Whitman Eye Center
Rockwall, TX 75032-6504
Phone (214) 754-0000

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3849TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
JW Eye Associates, PLLC Optometrist Current Accepting new patients
JW Eye Associates, PLLC CurrentSince May 1, 2021 Accepting new patients
JW Eye Associates, PLLC Optometrist CurrentSince May 1, 2021 Accepting new patients
Ophthalmic Partners, PA Past Accepting new patients

Locations

910 N Davis Dr
Ste 400
Arlington, TX 76012
Phone (817) 461-0199

11442 N Central Expy
Dallas, TX 75243
Phone (214) 220-3937

1220 N Town East Blvd
Ste 220
Mesquite, TX 75150
Phone (972) 613-9000

3060 Communications Pkwy
Ste 205
Plano, TX 75093
Phone (972) 769-2020

3021 E Renner Rd
Ste 100
Richardson, TX 75082
Phone (214) 750-0000

2380 S Goliad St
Ste 100
Rockwall, TX 75032
Phone (972) 771-2020

Interoperability endpoints

  • Direct secure messaging: psietmann@kwec.intellechartdirect.net

Organizations & group practices 4

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484438400000",
    "number": "1558356162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10363 FERRY FARM LN",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750356955",
            "telephone_number": "214-886-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10363 FERRY FARM LN",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750356955",
            "telephone_number": "214-886-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIETMANN",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2017-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3849TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.