NPIMap

Organization Active NPI

Beth Bruening PC

Doing business as Bruening Eye Specialists

  • Ophthalmology Physician
  • Dakota Dunes, SD
National Provider Identifier
1053446443
Registry record updated Aug 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
3577 Issued in SD
Legal business name
BETH BRUENING PC
Doing business as
Bruening Eye Specialists
Practice address
101 Tower Road
Suite 300
Dakota Dunes, SD 57049
Phone
(605) 217-4500
Fax
(605) 217-4503
NPI assigned
Feb 23, 2007
Last updated
Aug 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2017

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

Authorized official

Name
Terri Smith
Title
Billing Manager
Phone
(605) 217-4500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 650 SD
Specialist 174400000X 28135 IA
Ophthalmology Physician 207W00000X 3577 SD Primary

Addresses

Primary practice location

101 Tower Road
Suite 300
Dakota Dunes, SD 57049

Mailing address

PO Box 3566
Sioux City, IA 51102-3566
Phone (605) 217-4500

Other identifiers 6

IdentifierTypeStateIssuer
10025498700MedicaidNE
7760323MedicaidSD
2072876MedicaidIA
28135OtherIAIA LIC
3577OtherSDSD LIC
10025636300MedicaidNE

Other names 1

  • Bruening Eye Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070329000331 IA Part B Supplier - Clinic/Group Practice 4284738378 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Sioux City, IA; Orange City, IA; Onawa, IA; Le Mars, IA; Ida Grove, IA
O20070523000077 SD Part B Supplier - Clinic/Group Practice 4284738378 Receives reassigned benefits from 4 practitioners
Practice locations: Dakota Dunes, SD
O20100930029944 SD DME Supplier - Physician - Optometrist 4284738378 Practice locations: Dakota Dunes, SD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Bruening Eye Specialists101 Tower Rd, Dakota Dunes, SD 57049-5098(605) 217-4500 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Feb 26, 2007

National Provider Directory

National Provider Directory

Locations

5500 Sergeant Rd
Ste 200
Sioux City, IA 51106
Phone (605) 217-4500

101 Tower Rd
North Sioux City, SD 57049

101 Tower Rd
Ste 300
North Sioux City, SD 57049
Phone (605) 217-4500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501804800000",
    "number": "1053446443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3566",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511023566",
            "telephone_number": "605-217-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TOWER ROAD",
            "address_2": "SUITE 300",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "57049",
            "telephone_number": "605-217-4500",
            "fax_number": "605-217-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH BRUENING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2017-08-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "605-217-4500"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "650",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "28135",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SD",
            "license": "3577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025498700",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7760323",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2072876",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA LIC",
            "identifier": "28135",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD LIC",
            "identifier": "3577",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025636300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruening Eye Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dakota Dunes, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.