DR. GLEN D NYDAM O.D.
NPI 1003887688
Optometrist in Mitchell, SD
About Dr. Glen D Nydam O.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. GLEN D NYDAM O.D. (NPI 1003887688) is an individual optometrist in Mitchell, South Dakota, licensed in South Dakota (542) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (1996).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 6
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Glen D Nydam O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Glen Nydam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mitchell, SD 57301
- Reassigned Medicare billing, South Dakota enrollment
- 4 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 9
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 57301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Glen Nydam's NPI number?
The NPI number for Glen Nydam is 1003887688. It was assigned to this individual provider in the NPPES registry on January 31, 2006.
Where is Glen Nydam located?
Glen Nydam practices at 305 N Sanborn Blvd, Mitchell, SD 57301. The listed phone number is (605) 996-2537.
What is Glen Nydam's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Glen Nydam enrolled in Medicare?
Yes. Glen Nydam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Glen Nydam's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Glen Nydam reassigns Medicare benefits to Mabee Eye Clinic PC (Mitchell, SD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Glen Nydam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Glen Nydam accept?
Health plans from Avera Health Plans, Providence Health Plan, Sanford Health Plan, Wellmark Health Plan of Iowa, Inc. and Wellmark of South Dakota, Inc. list Glen Nydam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Glen Nydam was last updated on November 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Glen D Nydam, O.D. · NPI 1003887688
Optometrist provider in Mitchell, South Dakota. Individual provider, active in the CMS NPPES registry since January 31, 2006.
## Identity
- **NPI:** 1003887688 (Entity type: Individual)
- **Enumerated:** January 31, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 542 (South Dakota)
- **Sole proprietor:** No
## Practice location
- **Address:** 305 N SANBORN BLVD, Mitchell, SD 57301-2449
- **Phone:** (605) 996-2537 · **Fax:** (605) 996-0500
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Mabee Eye Clinic PC (NPI 1578519864, Mitchell, SD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Southern California College Of Optometry, class of 1996
## Record status
- **NPPES last updated:** November 10, 2022
- **Other identifiers:** Other 20048 (SD); Other 9170527 (SD); Medicaid 9203192 (SD); and 3 more
---
Source: [NPI Profile](https://npiprofile.com/npi/1003887688) · Data from the CMS NPPES public registry.