Elizabeth Kay Groetken, OD
Individual provider Active NPI Optometrist · Le Mars, IA
NPI 1760436802 · NPPES record last updated Oct 16, 2007
Key facts
- NPI
- 1760436802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 5431 (SD)
- Practice address
- 16 Central Ave NE
Le Mars, IA 51031-3515 - Phone
- (712) 546-8998
- Fax
- (712) 546-8971
- NPI assigned
- May 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
16 Central Ave NE
Le Mars, IA 51031-3515
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 12 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040331000677 | IA | Practitioner - Optometry | 7113919101 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5431 | SD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halsted'S PC | Optometrist | Current |
Accepting new patients |
Locations
16 Central Ave NE
Le Mars, IA 51031
Phone (712) 202-2728
Interoperability endpoints
- dregroetken@groetkenfamilyeyecare.direct.eyemdemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5431 | SD | Yes |
Addresses
Primary practice location
16 Central Ave NE
Le Mars, IA 51031-3515
Mailing address
16 Central Ave NE
PO Box 706
Le Mars, IA 51031-3515
Phone (712) 546-8998
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28406 | Other | IA | BCBS |
| 11206 | Other | IA | MIDLANDS |
| 0135230002 | Other | IA | CIGNA MEDICARE |
| 2195669 | Medicaid | IA |
Other providers in Le Mars, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.