Individual provider Active NPI

Gregory J Bruening, O.D.

  • Optometrist
  • Omaha, NE
National Provider Identifier
1811909476
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1001 Issued in NE
Practice address
6751 N 72ND St
Suite 105
Omaha, NE 68122-1746
Phone
(402) 572-2020
Fax
(402) 572-2150
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1001 NE Primary
Optometrist 152W00000X 02128 IA

Addresses

Primary practice location

6751 N 72ND St
Suite 105
Omaha, NE 68122-1746

Mailing address

6751 N 72ND St
Suite 105
Omaha, NE 68122-1746
Phone (402) 572-2020

Other identifiers 8

IdentifierTypeStateIssuer
2200237OtherNEUHC OF THE MIDLANDS
93317OtherNECOVENTRY
0514190MedicaidIA
06987OtherNEBCBS NE
47067295013MedicaidNE
96473OtherIABCBS IA
22882OtherNEMIDLANDS CHOICE
NEREX01660OtherNEMUTUAL OF OMAHA

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
I20100625000135 NE Practitioner - Optometry 6901937572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

848 Cornhusker Rd
Suite 105
Bellevue, NE 68123-4445
Phone (402) 293-1840

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Nov 2, 2020 Accepting new patients
Shoptikal LLC Optometrist CurrentSince Nov 2, 2020 Accepting new patients

Locations

848 Cornhusker Rd
Ste 105
Bellevue, NE 68123
Phone (402) 293-1840

2208 N Webb Rd
#4038
Grand Island, NE 68803
Phone (308) 382-7661

3044 S 84th St
Ste 1
Omaha, NE 68124
Phone (402) 391-1143

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811909476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6751 N 72ND ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221746",
            "telephone_number": "402-572-2020",
            "fax_number": "402-572-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6751 N 72ND ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221746",
            "telephone_number": "402-572-2020",
            "fax_number": "402-572-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUENING",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1001",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02128",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC OF THE MIDLANDS",
            "identifier": "2200237",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "93317",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0514190",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE",
            "identifier": "06987",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47067295013",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IA",
            "identifier": "96473",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "22882",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUTUAL OF OMAHA",
            "identifier": "NEREX01660",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.