Individual provider Active NPI

Miranda Dusek Thompson, OD

  • Optometrist
  • Grafton, ND
National Provider Identifier
1033092747
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
838 Issued in ND
Practice address
415 Hill Ave
Grafton, ND 58237-1001
Phone
(701) 352-1370
NPI assigned
Jul 29, 2025
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 838 ND Primary

Addresses

Primary practice location

415 Hill Ave
Grafton, ND 58237-1001

Mailing address

770 E 9TH St
Grafton, ND 58237-1621
Phone (701) 520-4616

Other practice location 1

2900 S Columbia Rd
Grand Forks, ND 58201-6070
Phone (701) 746-6745

Other names 1

  • Miranda Dusek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20250822000996 ND Practitioner - Optometry 8527568732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lvctr PLLCGroup PAC ID 2062696669, 4 clinicians
Heartland Eye Care, PCGroup PAC ID 2466442041, 5 clinicians

Practice addresses (Care Compare)

2900 S Columbia Rd
Grand Forks, ND 58201-6070
Phone (701) 746-6745

415 Hill Ave
Grafton, ND 58237-1001
Phone (701) 352-1370

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
838NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Eye Care, P.C. Optometrist CurrentSince Aug 18, 2025 Accepting new patients
Lvctr PLLC Optometrist CurrentSince Oct 6, 2025 Accepting new patients
Heartland Eye Care, PC Optometrist CurrentSince Aug 18, 2025 Accepting new patients
Lifetime Vision Center, LLC Optometrist PastSince Oct 6, 2025 Accepting new patients

Locations

415 Hill Ave
Grafton, ND 58237
Phone (701) 352-1370

2900 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 746-6745

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1033092747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 E 9TH ST",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371621",
            "telephone_number": "701-520-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HILL AVE",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371001",
            "telephone_number": "701-352-1370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 S Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582016070",
            "country_code": "US",
            "telephone_number": "701-746-6745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MIRANDA",
        "middle_name": "DUSEK",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-29",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "DUSEK",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grafton, ND

Sources for this page

Verify at the official NPI Registry.