Northeast Eyecare PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1396 Issued in NE

Legal business name

NORTHEAST EYECARE PC

Practice address

101 W Decatur St
West Point, NE 68788-1407

Phone

(402) 372-3266

Fax

(402) 372-5736

NPI assigned

Mar 18, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Brandon Ridder, ODNPI 1851731459

Title

Owner

Phone

(402) 372-3266

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NE2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Northeast Eyecare PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northeast Eye Care, PC

  • Optometrist
  • Oakland, NE
  • NPI 1568839488
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon Ridder, O.D.

  • Optometrist
  • West Point, NE
  • NPI 1851731459
  Medicare reassignment Care Compare group NPD Authorized official
• Emily Joann Wietfeld, O.D.

  • Optometrist
  • West Point, NE
  • NPI 1609447986
  Medicare reassignment Care Compare group NPD
• Jason Gerard Jedlicka, O.D.

  • Optometrist
  • Bloomington, IN
  • NPI 1669484622
  NPD (past)

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1649697491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W DECATUR ST",
            "city": "WEST POINT",
            "state": "NE",
            "postal_code": "687881407",
            "telephone_number": "402-372-3266",
            "fax_number": "402-372-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W DECATUR ST",
            "city": "WEST POINT",
            "state": "NE",
            "postal_code": "687881407",
            "telephone_number": "402-372-3266",
            "fax_number": "402-372-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-18",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "RIDDER",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-372-3266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264775-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264106-00",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "25136",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "8422",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "7748",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Nichole Monson I
• Jilinda Kay Mortensen, PTA
• Alicia Marie Nebuda
• Julie Ann Neiman, OT
• Terry F Nelson, PT
• Doreen O'Connor
• Abbi Gay Oligmueller, PT, DPT
• Jayalynn M Oltrogge
• Stacie R. Ortmeier, RD, LMNT
• Monica Parra Castro

• Optometrist in West Point, NE
• Providers in West Point, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.