Individual provider Active NPI

Dennis Michael Nietling, O.D.

  • Optometrist
  • Denison, TX
National Provider Identifier
1750586707
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2861TG Issued in TX
Practice address
417 W Main St
Denison, TX 75020-3126
Phone
(903) 465-3815
Fax
(903) 465-0718
NPI assigned
Jun 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2861TG TX Primary

Addresses

Primary practice location

417 W Main St
Denison, TX 75020-3126

Mailing address

417 W Main St
Denison, TX 75020-3126
Phone (903) 465-3815

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NOD@nietlingoptical.com Other

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
I20031212000521 TX Practitioner - Optometry 5991601817

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

417 W Main St
Denison, TX 75020-3126

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2861TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nietling Optical Optometrist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1750586707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W MAIN ST",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750203126",
            "telephone_number": "903-465-3815",
            "fax_number": "903-465-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W MAIN ST",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750203126",
            "telephone_number": "903-465-3815",
            "fax_number": "903-465-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETLING",
        "first_name": "DENNIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2861TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NOD@nietlingoptical.com",
            "affiliation": "N",
            "endpointDescription": "secure office email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "office email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "417 W Main St",
            "city": "Denison",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750203126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

Verify at the official NPI Registry.