Individual provider Active NPI

Scott L Greder, O.D.

  • Optometrist
  • Omaha, NE
National Provider Identifier
1609858638
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1149 Issued in NE
Practice address
4353 Dodge St
Omaha, NE 68131-2709
Phone
(402) 552-2020
NPI assigned
Nov 16, 2005
Last updated
Jan 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1149 NE Primary

Addresses

Primary practice location

4353 Dodge St
Omaha, NE 68131-2709

Mailing address

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

Other identifiers 1

IdentifierTypeStateIssuer
47080542866MedicaidNE

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
I20100625000897 NE Practitioner - Optometry 0840321477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Care PCGroup PAC ID 8628960572, 24 clinicians

Practice addresses (Care Compare)

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

Merit-based Incentive Payment System (MIPS)

Final score
78.02 of 100Reported as group
Quality
65.69
Promoting interoperability
89
Improvement activities
40
Cost
70.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1149NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Care PC CurrentSince Aug 1, 1999 Accepting new patients
Midwest Eye Care, PC Optometrist CurrentSince Aug 1, 1999 Accepting new patients
Midwest Eye Care, PC Optometrist Past Accepting new patients

Locations

715 Harmony St
Ste 300
Council Bluffs, IA 51503
Phone (712) 388-2600

4353 Dodge St
Omaha, NE 68131
Phone (402) 502-5599

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, 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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1609858638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020",
            "fax_number": "402-552-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREDER",
        "first_name": "SCOTT",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47080542866",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.