Stephen Philip Gildersleeve, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1353 Issued in NE

Practice address

3200 O St.
Lincoln, NE 68510

Phone

(402) 475-9113

Fax

(402) 475-8084

NPI assigned

Aug 5, 2010

Last updated

Jul 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Southern California College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

International Eyecare Center LLCGroup PAC ID 0244125235, 20 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• International Eyecare Center LLC

  • Optometrist
  • Quincy, IL
  • NPI 1760405047

  NE

  Medicare reassignment Care Compare group NPD
• International Eyecare Center Inc

  dba Malbar Vision

  • Optometrist
  • Omaha, NE
  • NPI 1386825610
  NPD
• International Eyecare Center, Inc.

  dba Malbar Vision

  • Optometrist
  • La Vista, NE
  • NPI 1740461979
  NPD (past)

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1861706509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 O ST.",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68510",
            "telephone_number": "402-475-9113",
            "fax_number": "402-475-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 O ST.",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68510",
            "telephone_number": "402-475-9113",
            "fax_number": "402-475-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDERSLEEVE",
        "first_name": "STEPHEN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-05",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1353",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2796",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026004700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Katlyn Gifford
• Delia Marie Gilbertsen, PA-C
• Chris Edward Gilbertson
• Breanne Gilchrist, LCSW
• Laura Gildea
• Nicholas Giles, PSYD
• Dameon Gilfillan, LADC
• Jody Renee Gilfillan, MAA,LADC
• Gabrielle Jane Gill
• Mekyla Gill

• Optometrist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.