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PREMIER FAMILY EYE CARE, PC
NPI 1699919852
Optometrist in Custer, SD

Active since April 30, 2009
322 MOUNT RUSHMORE RD, SUITE 120, CUSTER, SD 57730(605) 673-2716(605) 673-2017 Get Directions Write a Review

NPPES record last updated: June 29, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Premier Family Eye Care, Pc NPPES

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

PREMIER FAMILY EYE CARE, PC (NPI 1699919852) is a healthcare organization registered as an optometrist in Custer, South Dakota and active in the NPI registry since April 2009. The organization lists Nathan Wiederholt, Owner, as its authorized official.

NPPES Registry Identity

NPI1699919852
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NamePREMIER FAMILY EYE CARE, PC
Location Address322 MOUNT RUSHMORE RD, SUITE 120Custer, SD 57730-1936
Mailing Address322 Mount Rushmore Rd, Suite 120Custer, SD 57730-1936 · (605) 673-2716 · Fax (605) 673-2017
Phone(605) 673-2716
Fax(605) 673-2017
Organization SubpartNo
Authorized OfficialNathan WiederholtOwner · (605) 673-2716
Enumeration DateApril 30, 2009
Last NPPES UpdateJune 29, 2010
✔ NPI 1699919852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in SD · 656
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.
322 MOUNT RUSHMORE RD, Custer, SD 57730
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Other Identifiers 4

Medicare NSC6339560001
Medicare PINDT0503
Medicaid9203883SD
Medicare PINS103300

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premier Family Eye Care, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Premier Family Eye Care, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nathan Wiederholt, O.D.
Optometry
NPI 1447414461
322 MOUNT RUSHMORE RD SUITE 120
Custer, SD 57730
(605) 673-2716
✔ PECOS✔ Accepts Medicare0.8 mi

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

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 Premier Family Eye Care, PC's NPI number?

The NPI number for Premier Family Eye Care, PC is 1699919852. It was assigned to this organization in the NPPES registry on April 30, 2009.

Where is Premier Family Eye Care, PC located?

Premier Family Eye Care, PC is located at 322 Mount Rushmore Rd Suite 120, Custer, SD 57730. The listed phone number is (605) 673-2716.

What is Premier Family Eye Care, PC's specialty?

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

Is Premier Family Eye Care, PC enrolled in Medicare?

Yes. Premier Family Eye Care, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premier Family Eye Care, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Premier Family Eye Care, PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Premier Family Eye Care, PC was last updated on June 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.