| Professional Provider Enterprise Llc | |
|
10826 Old Mill Rd Ste 101, Omaha, NE 68154-2660 | |
| (402) 898-3232 | |
| (402) 898-3234 |
| Full Name | Professional Provider Enterprise Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 10826 Old Mill Rd Ste 101, Omaha, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770852196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 01891 (Iowa) | Primary |
| Provider Name | Lyndon Graves |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205886736 PECOS PAC ID: 7517879000 Enrollment ID: I20040331000640 |
| Provider Name | Heather Yvonne Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013033075 PECOS PAC ID: 4082634183 Enrollment ID: I20101029000193 |
| Provider Name | Lucas J Bell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154679561 PECOS PAC ID: 3678798410 Enrollment ID: I20140710001415 |
| Provider Name | Bryan Kent Larson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356724272 PECOS PAC ID: 5597065458 Enrollment ID: I20151125000100 |
| Provider Name | Norman Douglas Streifel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275526444 PECOS PAC ID: 6204801517 Enrollment ID: I20180308000011 |
| Provider Name | Charles Vanaki |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770896201 PECOS PAC ID: 2264606441 Enrollment ID: I20220719001800 |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Provider Enterprise Llc 10826 Old Mill Rd Ste 101, Omaha, NE 68154-2660 Ph: (888) 840-3032 | Professional Provider Enterprise Llc 10826 Old Mill Rd Ste 101, Omaha, NE 68154-2660 Ph: (402) 898-3232 |
Krystal Ann Wells, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4353 Dodge St, Omaha, NE 68131 Phone: 402-552-2020 Fax: 402-552-2367 | |
Heartland Eye Consultants Llc Optometrist Medicare: Medicare Enrolled Practice Location: 9900 Nicholas St Ste 250, Omaha, NE 68114 Phone: 402-493-6500 Fax: 402-493-4370 | |
Jennifer Lynn Brammeier, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 12850 L Street, Walmart Vision Center, Omaha, NE 68137 Phone: 402-697-1852 Fax: 402-697-4834 | |
Hospital Eye Associates Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 601 N 30th St, Ste 3700, Omaha, NE 68131 Phone: 402-280-4102 | |
Dr. Matthew Luke Willis, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4353 Dodge St, Omaha, NE 68131 Phone: 402-552-2020 Fax: 402-552-2367 | |
Muriel Jepsen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6304 N 99th St, Omaha, NE 68134 Phone: 402-492-9440 Fax: 402-492-9441 | |
Frank E Graf, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 988102 Nebraska Medical Ctr, Omaha, NE 68198 Phone: 402-559-2020 Fax: 402-559-5514 |