Individual provider Active NPI

Jeremy W McMeen, O.D.

  • Optometrist
  • Superior, NE
National Provider Identifier
1790774347
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1093 Issued in NE
Practice address
358 N Central
Superior, NE 68978-1715
Phone
(402) 879-3233
Fax
(402) 879-3378
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1093 NE Primary
Optometrist 152W00000X 1489 KS

Addresses

Primary practice location

358 N Central
Superior, NE 68978-1715

Mailing address

358 N Central
Superior, NE 68978-1715
Phone (402) 879-3233

Other identifiers 5

IdentifierTypeStateIssuer
100263170AMedicaidKS
36742OtherNEBCBS NEBRASKA
410033190OtherNERAILROAD MEDICARE
47080270700MedicaidNE
49839OtherKSBCBS KANSAS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060811000441 NE Practitioner - Optometry 9436152444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

358 N Central
Superior, NE 68978-1715

358 N Central Ave
Superior, NE 68978-1715

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1489KSMDClinical Social Worker
1093NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Vision PC CurrentSince Mar 22, 2004 Accepting new patients
Geiger & Dietze Ophthalmology Past Accepting new patients

Locations

358 N Central Ave
Superior, NE 68978
Phone (402) 879-3223

Organizations & group practices 2

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1790774347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 N CENTRAL",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689781715",
            "telephone_number": "402-879-3233",
            "fax_number": "402-879-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 N CENTRAL",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689781715",
            "telephone_number": "402-879-3233",
            "fax_number": "402-879-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMEEN",
        "first_name": "JEREMY",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1093",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1489",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100263170A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NEBRASKA",
            "identifier": "36742",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410033190",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47080270700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS",
            "identifier": "49839",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, NE

Sources for this page

Verify at the official NPI Registry.