Individual provider Active NPI

Michael O'Neal

  • Optometrist
  • North Sioux City, SD
National Provider Identifier
1932647054
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
736 Issued in SD
Practice address
305 Dakota Dunes Blvd
North Sioux City, SD 57049-5176
Phone
(712) 420-3068
NPI assigned
Feb 9, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 736 SD Primary

Addresses

Primary practice location

305 Dakota Dunes Blvd
North Sioux City, SD 57049-5176

Mailing address

22847 East 16
Hornick, IA 51026
Phone (712) 420-3068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD2 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
I20170816003231 IA Practitioner - Optometry 0941572531 Reassigns benefits to 1 organization
I20170822002963 SD Practitioner - Optometry 0941572531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawkeye Clinic of South Dakota PLLCGroup PAC ID 7214919935, 2 clinicians

Practice addresses (Care Compare)

305 Dakota Dunes Blvd
Dakota Dunes, SD 57049-5176
Phone (605) 232-6900

38 Central Ave NE
Le Mars, IA 51031-3515
Phone (712) 546-6803

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hawkeye Clinic of Lemars Optometrist CurrentSince Jul 11, 2017 Accepting new patients
Hawkeye Clinic of South Dakota PLLC Optometrist CurrentSince Jul 11, 2017 Accepting new patients
Hawkeye Clinic of South Dakota Optometrist Past Accepting new patients
Hawkeye Exact, LLC Optometrist PastSince Jan 16, 2018 Accepting new patients

Locations

38 Central Ave NE
Le Mars, IA 51031
Phone (712) 546-6803

305 Dakota Dunes Blvd
North Sioux City, SD 57049
Phone (605) 232-6900

Organizations & group practices 4

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": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1932647054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22847 EAST 16",
            "city": "HORNICK",
            "state": "IA",
            "postal_code": "51026",
            "telephone_number": "712-420-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 DAKOTA DUNES BLVD",
            "city": "NORTH SIOUX CITY",
            "state": "SD",
            "postal_code": "570495176",
            "telephone_number": "712-420-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-09",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Sioux City, SD

Sources for this page

Verify at the official NPI Registry.