CMS-1500 Box 24J / 33a • NPI
1053666800
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
152W00000X (CMS 41)
Licensed & Credentialed Eye and Vision Service Providers — Optometrist
Box 32 Service Location & ZIP+4
1909 HAMILTON BLVD, SIOUX CITY, IA, 51104-4148
✓ 9-Digit EDI 837 ZIP+4 (51104-4148)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1053666800 (ANGELA MARIE KOLBO, O. D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
No
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1053666800)
Medicare Beneficiaries
316
Total Billed Services
941
Distinct CPT/HCPCS Codes
19
Medicare Allowed Total
$66,634.88
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
92004 | New patient complete exam of visual system | 29 |
92014 | Established patient complete exam of visual system | 249 |
92083 | Exam of visual field with extended testing | 47 |
92133 | Imaging of optic nerve | 42 |
92134 | Imaging of retina | 156 |
92250 | Photography of the retina | 277 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 79 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 20 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Combigan Brimonidine Tartrate/Timolol | 19 | <11 |
| Dorzolamide Hcl Dorzolamide Hcl | 21 | <11 |
| Dorzolamide-Timolol Dorzolamide Hcl/Timolol Maleat | 13 | <11 |
| Fluorometholone Fluorometholone | 13 | <11 |
| Latanoprost Latanoprost | 129 | 29 |
| Lumigan Bimatoprost | 36 | <11 |
| Neomycin-Polymyxin-Dexameth Neomycin/Polymyxin B/Dexametha | 24 | 17 |
| Prednisolone Acetate Prednisolone Acetate | 11 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1053666800 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ANGELA MARIE KOLBO, O. D. |
| Plain-English Specialty | Licensed & Credentialed Eye and Vision Service Providers — Optometrist NUCC Code: 152W00000X (Optometrist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1909 HAMILTON BLVD, SIOUX CITY, IA, 51104-4148 |
| Practice Telephone / Fax | Tel: (712) 252-4333 | Fax: (712) 252-1633 |
| Administrative Mailing Address | 1909 HAMILTON BLVD, SIOUX CITY, IA, 51104-4148 |
| Enumeration & Last Sync | Enumerated: 2012-07-18 | CMS Record Updated: 2026-08-24 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (152W00000X)
What Does Taxonomy Code 152W00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 152W00000X translates to:
"Licensed & Credentialed Eye and Vision Service Providers — Optometrist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ANGELA MARIE KOLBO, O. D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
152W00000X — OptometristPlain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist | State: IA | License: 002547 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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