- Medicare in Grand Island, NE

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is a medicare enrolled "Eyewear Supplier" provider in Grand Island, Nebraska. Their current practice location is 1919 N Diers Ave Ste B, Grand Island, Nebraska. You can reach out to their office (for appointments etc.) via phone at (308) 382-7661.

is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1952967325.

Contact Information

1919 N Diers Ave Ste B,
Grand Island, NE 68803-1284
(308) 382-7661
Not Available

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityEyewear Supplier
Location1919 N Diers Ave Ste B, Grand Island, Nebraska
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1952967325
  • Provider Enumeration Date: 05/11/2019
  • Last Update Date: 11/29/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1456684471
  • Enrollment ID: O20190709002988

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1952967325NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist (* (Not Available))Secondary
332H00000XEyewear Supplier (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameRobert David Sanders
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1144273327
PECOS PAC ID: 1557329653
Enrollment ID: I20041221000445
Provider NameAnthony James Manthey
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1669423869
PECOS PAC ID: 1658339775
Enrollment ID: I20041221000601
Provider NameRussell D Smith
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1285687442
PECOS PAC ID: 7315905452
Enrollment ID: I20041221000741
Provider NameGregory P Gerdes
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1497707244
PECOS PAC ID: 0840203782
Enrollment ID: I20060719000321
Provider NameMark Jay Witte
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1699714964
PECOS PAC ID: 3577566785
Enrollment ID: I20060808000481
Provider NameDonald R Krysl
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1730118233
PECOS PAC ID: 1658374236
Enrollment ID: I20060821000556
Provider NameJason L Hawley
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1235275983
PECOS PAC ID: 2567545346
Enrollment ID: I20080218000190
Provider NameMelinda K Kennel
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1013908656
PECOS PAC ID: 4486657905
Enrollment ID: I20080731000795
Provider NameGregory J Bruening
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1811909476
PECOS PAC ID: 6901937572
Enrollment ID: I20100625000135
Provider NameMatthew S Porn
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1659752368
PECOS PAC ID: 5698045318
Enrollment ID: I20170727003037
Provider NameZachery Baumfalk
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1871002170
PECOS PAC ID: 5698021707
Enrollment ID: I20180703001575
Provider NameSeth Lambert
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1336459312
PECOS PAC ID: 9830500461
Enrollment ID: I20201202002663
Provider NameStephanie D Dufner
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1518272798
PECOS PAC ID: 2769897511
Enrollment ID: I20210209001601
Provider NameMary Elizabeth Boeckman
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1134791981
PECOS PAC ID: 3173926698
Enrollment ID: I20210721003055
Provider NameChelsea Lynn Lula
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1023681467
PECOS PAC ID: 5193121630
Enrollment ID: I20210908001905
Provider NameEmily Weakland
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1265002521
PECOS PAC ID: 7810393147
Enrollment ID: I20210910001915
Provider NameTracey Payne
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1922140748
PECOS PAC ID: 7214335900
Enrollment ID: I20211011001649
Provider NameSadie Cole
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1578811493
PECOS PAC ID: 7315339876
Enrollment ID: I20220113002273
Provider NameJacqueline Carmen Elizabeth Evans
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1053726315
PECOS PAC ID: 4587997473
Enrollment ID: I20220601002465
Provider NameLeann Goslak
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1205915451
PECOS PAC ID: 0840473484
Enrollment ID: I20220803001444
Provider NameDeanna Ippolito
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1225683121
PECOS PAC ID: 8426388257
Enrollment ID: I20221003001926
Provider NameJoel Robert Holmquist
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1013691484
PECOS PAC ID: 0840658019
Enrollment ID: I20230620002659
Provider NameMegan Kidd
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1417251471
PECOS PAC ID: 7012205727
Enrollment ID: I20231024000238

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. 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 AddressPractice Location Address

Po Box 19060,
Green Bay, WI 54307-9060

Ph: () -
1919 N Diers Ave Ste B,
Grand Island, NE 68803-1284

Ph: (308) 382-7661

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.