Dr. Eric E Miedema
Optometrist

Address: 1700 Mchenry Avenue, Suite 77, Modesto, CA 95350-4318
Phone: 2095244626

Dr. Eric E Miedema (NPI# 1336213735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1336213735
Entity Type Individual
Full Name Dr. Eric E Miedema
Credential OD
Gender Male
Practice Address 1700 Mchenry Avenue
Suite 77
Modesto
CA 95350-4318
Practice Telephone 2095244626
Practice Fax Number 2095241046
Mailing Address 1700 Mchenry Avenue
Suite 77
Modesto
CA 95350-4318
Mailing Telephone 2095244626
Mailing Fax Number 2095241046
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-11-17
Last Update Date 2007-12-27

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 152W00000X Optometrist Eye and Vision Services Providers OPT9947TPA CA

Other Provider Identifier

State Identifier Issuer Type Code
94217822195350B2 OTHER TRICARE
CA SD0099470 MEDICAID
410020358 OTHER RAILROAD MEDICARE

Physician Overview

NPI 1336213735
PAC ID by PECOS 4183791411
Professional Enrollment ID I20081117000532
Full Name Eric E Miedema
Organization Legal Name STANISLAUS VISION ASSOCIATES OPTOMETRIC GROUP INC
Phone Number 2095244626
Gender M
Medical School ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduation Year 1992
Primary Specialty OPTOMETRY
Group Practice PAC ID 9133296460
Number of Group Practice Members 3
Accepts Medicare Assignment Y

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_226_1 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 100%

Taxonomy Information

Taxonomy Code 152W00000X
Grouping Eye and Vision Services Providers
Classification Optometrist

Taxonomy Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578913869 Lidia Tekie Optometrist 1208 Floyd Ave Bldg C, Modesto, CA 95350-2470 2016-06-16
1215186598 Lina Lee Optometrist 3200 Sisk Rd, Modesto, CA 95356-0546 2008-09-11
1366600082 Peter S. Klem Fred P. Guarcello Ptr Optometrist 4028 Dale Road, Suite 102, Modesto, CA 95356-9561 2008-05-29
1104001965 Erika Bray Ortega Optometrist 2401 E Orangeburg Ave Ste 280, Modesto, CA 95355-3396 2007-12-29
1114131141 Stanislaus Optometric Center, Inc. Optometrist 4028 Dale Rd Ste 102, Modesto, CA 95356-9505 2007-05-09
1255450524 Richard Alan Portillo Optometrist 1624 I St, Modesto, CA 95354-1122 2007-03-28
1619028842 Lincoln Andrus Service Jr. Optometrist 3500 Sisk Rd, Best Plaza Ste E, Modesto, CA 95356-0550 2007-01-15
1336201615 Keith Yun Kong Wong Optometrist 3401 Dale Rd, Suite 300, Modesto, CA 95356-0505 2006-12-14
1760558498 L Edward Elliott Et Al Ptr Elliott L Edward Gen Ptr Optometrist 3601 Coffee Rd, Modesto, CA 95355 2006-11-27
1841362381 Gary Mark Cushing Optometrist 2911 E Hatch Rd, Modesto, CA 95351-4921 2006-11-13
Find all providers in MODESTO

Office Location

Street Address 1700 MCHENRY AVENUE
SUITE 77
City MODESTO
State CA
Zip Code 95350-4318

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457425852 Stanislaus Vision Associates Optometric Group Inc Optometrist 1700 Mchenry Avenue, Suite 77, Modesto, CA 95350-4318 2006-11-17
1255405650 Spencer H Whatcott Optometrist 1700 Mchenry Avenue, Suite 77, Modesto, CA 95350-4318 2006-11-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588211254 Karla Junuen Toscano Licensed Vocational Nurse 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 2019-08-19
1831694769 Loretta Myers-weber Nurse Practitioner 1510 Florida Ave Ste A, Modesto, CA 95350 2018-03-23
1720599632 Coral Alejandra Amador Counselor 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 2017-10-18
1053820522 Pannu and Henne Dental Corp. Dentist 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 2017-09-27
1346779709 Kevin Sotelo Behavior Technician 2630 W Rumble Road, Modesto, CA 95350 2017-06-08
1255869566 Hoa Xuan Phan Family Medicine 1441 Florida Ave Ste 200, Modesto, CA 95350 2017-05-31
1356881163 Brady S Marshall Dentist 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 2017-02-27
1750755476 Caremore Health Plan Nurse Practitioner 1234 Mchenry Avenue, Modesto, CA 95350 2015-11-18
1821461104 Michael Lopez Dental Corporation Dentist 2103 Mchenry Avenue, Suite C, Modesto, CA 95350 2015-11-09
1215329487 Suave Dental Inc Clinic/Center 3025 Mchenry Ave Ste N, Modesto, CA 95350 2015-02-25
Find all providers in zip 95350

Competitor

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City MODESTO
Zip Code 95350

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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