Individual provider Active NPI

Steven Wayne Samuelson, MD

  • Ophthalmology Physician
  • Fremont, NE
National Provider Identifier
1649273061
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
18080 Issued in NE
Practice address
2827 N Clarkson St
Fremont, NE 68025-7714
Phone
(402) 721-7222
Fax
(402) 721-2473
NPI assigned
May 31, 2005
Last updated
Jan 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 18080 NE Primary

Addresses

Primary practice location

2827 N Clarkson St
Fremont, NE 68025-7714

Mailing address

2827 N Clarkson St
Fremont, NE 68025-7714
Phone (402) 721-7222

Other identifiers 1

IdentifierTypeStateIssuer
47066963701MedicaidNE

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100130000384 NE Practitioner - Ophthalmology 1052326238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Care, PC Ophthalmology CurrentSince Jun 1, 2022 Accepting new patients

Locations

2827 N Clarkson St
Fremont, NE 68025
Phone (402) 721-2473

13500 California St
Omaha, NE 68154

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

Organizations & group practices 1

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1649273061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 N CLARKSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257714",
            "telephone_number": "402-721-7222",
            "fax_number": "402-721-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 N CLARKSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257714",
            "telephone_number": "402-721-7222",
            "fax_number": "402-721-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "STEVEN",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NE",
            "license": "18080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47066963701",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.