Individual provider Active NPI

Zachary Brown, O.D.

  • Optometrist
  • Omaha, NE
National Provider Identifier
1790048403
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1377 Issued in NE
Practice address
4353 Dodge St
Omaha, NE 68131-2709
Phone
(402) 552-2020
Fax
(402) 552-2367
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002611 IA
Optometrist 152W00000X 1377 NE Primary

Addresses

Primary practice location

4353 Dodge St
Omaha, NE 68131-2709

Mailing address

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120810000840 NE Practitioner - Optometry 7012163777 Reassigns benefits to 2 organizations
I20180928001662 IA Practitioner - Optometry 7012163777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Provider Enterprise LLCGroup PAC ID 0840458667, 8 clinicians
Senior Vision Services LLCGroup PAC ID 8820256001, 9 clinicians

Practice addresses (Care Compare)

2063 Creek Side Dr
Suite 123
Papillion, NE 68046-4192
Phone (402) 207-2311

2730 Crow Creek Rd
Bettendorf, IA 52722-2066
Phone (563) 332-7463

610 S Polk St
Papillion, NE 68046-2548
Phone (402) 339-7700

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

State licenses

LicenseStateTypeSpecialty
1377NEMDAddiction (Substance Use Disorder) Counselor
002611IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Provider Enterprise LLC Optometrist CurrentSince May 1, 2025 Accepting new patients
Walnut Creek Eyecare LLC Optometrist CurrentSince May 7, 2024 Accepting new patients
Senior Vision Services LLC Optometrist CurrentSince May 1, 2025 Accepting new patients
Heidi a Hanisch OD PC Optometrist Past Accepting new patients
Focused Eye Care Past Accepting new patients

Locations

2730 Crow Creek Rd
Bettendorf, IA 52722
Phone (563) 332-7463

7 Elliott St
Council Bluffs, IA 51503
Phone (531) 867-4466

3800 Commerce Blvd
Davenport, IA 52807
Phone (563) 332-7463

5837 Winwood Dr
Johnston, IA 50131
Phone (515) 240-1100

2242 Wright St
Blair, NE 68008
Phone (402) 426-4663

10826 Old Mill Rd
Ste 101
Omaha, NE 68154

1540 N 72nd St
Omaha, NE 68114
Phone (402) 393-8693

610 S Polk St
Papillion, NE 68046
Phone (402) 339-7700

2063 Creek Side Dr
Ste 123
Papillion, NE 68046
Phone (402) 207-2311

Organizations & group practices 6

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1790048403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020",
            "fax_number": "402-552-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020",
            "fax_number": "402-552-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ZACHARY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002611",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.