Philip Lyle Gildersleeve, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

856 Issued in NE

Practice address

612 N 4TH St
Pob 818
Oneill, NE 68763-1326

Phone

(402) 336-2220

Fax

(402) 336-4845

NPI assigned

Sep 20, 2006

Last updated

Nov 15, 2007By 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 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Southern California College of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

65.51 of 100Reported as individual

Quality

31.02

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Oneill Family Eyecare PC

  • Optometrist
  • O'Neill, NE
  • NPI 1437200961
  Medicare reassignment NPD Authorized official
• Health Innovation Technologies, Inc

  • Podiatric Assistant
  • O'Neill, NE
  • NPI 1609080696
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1740388990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N 4TH ST",
            "address_2": "POB 818",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631326",
            "telephone_number": "402-336-2220",
            "fax_number": "402-336-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N 4TH ST",
            "address_2": "POB 818",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631326",
            "telephone_number": "402-336-2220",
            "fax_number": "402-336-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDERSLEEVE",
        "first_name": "PHILIP",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00410801",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara K. Frederick, PA-C
• Cheryl Frisch
• Jane Fry-Harner, PLADC
• Monique Gamage
• Kayla Geffre
• Malerie Frances Gokie
• Angela Marie Gray, PHARMD
• Gutshall Kohle Pelster Eyecare, LLC (Gutshall Kohle Pelster Eyecare)
• Barbara J Gutshall, MD
• Carl Scott Gutshall, O.D.

• Optometrist in O'Neill, NE
• Providers in O'Neill, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.