JACOB MICHAEL DIEDRICH OD
NPI 1407415599
Optometrist in Sioux City, IA

Active since June 11, 2019PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
5001 SERGEANT RD STE 45, SIOUX CITY, IA 51106(712) 224-4600 Get Directions Write a Review

NPPES record last updated: February 17, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 17, 2021, Feb 4, 2021, Jun 11, 2019 (3 updates tracked since 2019).

About Jacob Michael Diedrich Od NPPES

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

JACOB MICHAEL DIEDRICH OD (NPI 1407415599) is an individual optometrist in Sioux City, Iowa, licensed in South Dakota (758) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Sioux Falls, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1407415599
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameJACOB MICHAEL DIEDRICHCredential: OD
Location Address5001 SERGEANT RD STE 45Sioux City, IA 51106-4777
Mailing Address7507 S Beal Ave Apt 13Sioux Falls, SD 57108-4918
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJune 11, 2019
Last NPPES UpdateFebruary 17, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 17, 2021
NPI 1407415599 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 SD · 758 Licensed in IA · 096566
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.
5001 SERGEANT RD STE 45, Sioux City, IA 51106

Secondary Practice Location 1

Location 15129 S Western AveSioux Falls, SD 57108-2670 · Phone (605) 332-2231 · Fax (605) 330-9519

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jacob Michael Diedrich Od 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.

PECOS PAC ID9436484458
PECOS Enrollment IDI20210305001744
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.

Areas of Expertise CMS Part B claims 6

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.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
129 services127 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
50 services43 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
35 services35 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
27 services26 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
13 services13 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 51106 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
$122.23 typical visit price
range $52.96 – $161.40
Typical copayment $30.55 (range $13.24 – $40.35)
Most-billed visit code 99204
Established Patient
$66.36 typical visit price
range $16.91 – $131.98
Typical copayment $16.59 (range $4.22 – $32.99)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

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 Jacob Diedrich's NPI number?

The NPI number for Jacob Diedrich is 1407415599. It was assigned to this individual provider in the NPPES registry on June 11, 2019.

Where is Jacob Diedrich located?

Jacob Diedrich practices at 5001 Sergeant Rd Ste 45, Sioux City, IA 51106. The listed phone number is (712) 224-4600.

What is Jacob Diedrich's specialty?

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

Is Jacob Diedrich enrolled in Medicare?

Yes. Jacob Diedrich 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.

What insurance does Jacob Diedrich accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Medica and Providence Health Plan and 1 other insurer list Jacob Diedrich 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 Jacob Diedrich was last updated on February 17, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.