DR. BENJAMIN RANDALL GROTH O.D.
NPI 1073008314
Optometrist in Omaha, NE

Q: What is Benjamin Groth's NPI number?

The NPI number for Benjamin Groth is 1073008314. It was assigned to this individual provider in the NPPES registry on June 28, 2018.

Q: What is Benjamin Groth's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Groth was last updated on May 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 28, 2018PECOS Enrolled

85.73/100

CMS Quality Rating

6751 N 72ND ST STE 105, OMAHA, NE 68122(402) 572-2020(402) 572-2150 Get Directions Write a Review

NPPES record last updated: May 19, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 19, 2021, Sep 16, 2019, Jun 28, 2018 (3 updates tracked since 2018).

On this page

About Dr. Benjamin Randall Groth O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BENJAMIN RANDALL GROTH O.D. (NPI 1073008314) is an individual optometrist in Omaha, Nebraska, licensed in Nebraska (1530) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1073008314

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. BENJAMIN RANDALL GROTHCredential: O.D.

Location Address6751 N 72ND ST STE 105Omaha, NE 68122-1746

Mailing Address6751 N 72nd St Ste 105Omaha, NE 68122-1746 · (402) 572-2020 · Fax (402) 572-2150

Phone(402) 572-2020

Fax(402) 572-2150

Sole ProprietorNo

Enumeration DateJune 28, 2018

Last NPPES UpdateMay 19, 20213 updates tracked since enumeration

NPPES CertifiedApril 6, 2021

✔ NPI 1073008314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in NE · 1530✔ Licensed in IA · 091798

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.

6751 N 72ND ST STE 105, Omaha, NE 68122

Open in Google Maps ↗

Secondary Practice Locations 3

Location 11540 Spring Valley DrHuntington, WV 25704-9300 · Phone (304) 429-6741

Location 26751 N 72nd St Ste 105Omaha, NE 68122-1746 · Phone (402) 572-2020

Location 3576 Boyson Rd NE Ste 104Cedar Rapids, IA 52402 · Phone (319) 373-3737

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Benjamin Randall Groth O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Benjamin Groth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Vision Park Family Eye Care, LLP

121 mi

Vision Therapy

2699 86TH ST
Urbandale, IA 50322

Reassigned Medicare billing, Iowa enrollment
7 clinicians in this Medicare group

NPI 1336102052 (515) 270-2490

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68122 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.35 typical visit price

range $52.69 – $160.21

Typical copayment $30.33 (range $13.17 – $40.05)

Most-billed visit code 99204

Established Patient

$66.00 typical visit price

range $16.90 – $131.25

Typical copayment $16.50 (range $4.22 – $32.81)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

85.73/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

52.43

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALYSSA ANN CALTA OD

Optometrist

6751 N 72ND ST STE 105
OMAHA, NE 68122

Douglas County (402) 572-2020

TYLER R JEVNE OD

Optometrist

6751 N 72ND ST STE 105
OMAHA, NE 68122

Douglas County (402) 572-2020

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 Benjamin Groth's NPI number?

The NPI number for Benjamin Groth is 1073008314. It was assigned to this individual provider in the NPPES registry on June 28, 2018.

Where is Benjamin Groth located?

Benjamin Groth practices at 6751 N 72nd St Ste 105, Omaha, NE 68122. The listed phone number is (402) 572-2020.

What is Benjamin Groth's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Benjamin Groth enrolled in Medicare?

Yes. Benjamin Groth is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Benjamin Groth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Groth reassigns Medicare benefits to Vision Park Family Eye Care, LLP (Urbandale, IA). 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 Benjamin Groth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Benjamin Groth was last updated on May 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.