Dr Nathan Henry Wiederholt, OD is a medicare enrolled "Optometrist" provider in Custer, South Dakota. He went to Pacific University - College Of Optometry and graduated in 2008 and has 17 years of diverse experience with area of expertise as Optometry. His current practice location is
322 Mount Rushmore Rd, Suite 120, Custer, South Dakota. You can reach out to his office (for appointments etc.) via phone at
(605) 673-2716.
Dr Nathan Henry Wiederholt is licensed to practice in South Dakota (license number 656) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1447414461.
Healthcare Provider's Profile
| Full Name | Dr Nathan Henry Wiederholt |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 17 Years |
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| Location | 322 Mount Rushmore Rd, Custer, South Dakota |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Nathan Henry Wiederholt attended and graduated from Pacific University - College Of Optometry in 2008
NPI Data:
- NPI Number: 1447414461
- Provider Enumeration Date: 07/18/2008
- Last Update Date: 06/16/2010
Medicare PECOS Information:
- PECOS PAC ID: 4688740665
- Enrollment ID: I20080828000233
Medical Identifiers
Medical identifiers for Dr Nathan Henry Wiederholt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1447414461 | NPI | - | NPPES |
| 9203883 | Medicaid | SD | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 656 (South Dakota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Nathan Henry Wiederholt allows following entities to bill medicare on his behalf.
| Provider Name | Premier Family Eye Care, Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1699919852
PECOS PAC ID: 6608927850
Enrollment ID: O20090629000168 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nathan Henry Wiederholt is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Nathan Henry Wiederholt, OD
322 Mount Rushmore Rd, Suite 120,
Custer, SD 57730-1936
Ph: (605) 673-2716 | Dr Nathan Henry Wiederholt, OD
322 Mount Rushmore Rd, Suite 120,
Custer, SD 57730-1936
Ph: (605) 673-2716 |
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