Jill Anita Pownell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T681 Issued in SD

Practice address

22 19TH St SE
Watertown, SD 57201-3938

Phone

(605) 753-3937

Fax

(605) 753-0472

NPI assigned

Jun 30, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Jill Anita Sandbakken Former name

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aimee M Schulte OD PCGroup PAC ID 5496709446, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aimee M Schulte OD PC

  • Optometrist
  • Watertown, SD
  • NPI 1649467895
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1023246873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 19TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "057-533-9376",
            "fax_number": "605-753-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 19TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "605-753-3937",
            "fax_number": "605-753-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWNELL",
        "first_name": "JILL",
        "middle_name": "ANITA",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002458",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "T681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421499499",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SD",
            "identifier": "4977608",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "S112121",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "SANDBAKKEN",
            "middle_name": "ANITA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Jo Pietz, O.D.
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• Kayla Ann Pinkert
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• Ryan Frederick Poppe, RN
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• Prairie Lakes Health Care System Inc (Prairie Lakes Brown Clinic)

• Optometrist in Watertown, SD
• Providers in Watertown, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.