Organization Active NPI

Conroy Eye Care PC

  • Optometrist
  • Milbank, SD
National Provider Identifier
1063479426
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SD491 Issued in SD
Legal business name
CONROY EYE CARE PC
Practice address
411 S Main St
Milbank, SD 57252-2424
Phone
(605) 432-5730
Fax
(605) 432-4324
NPI assigned
Apr 28, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. John Allen Conroy, ODNPI 1144219213
Title
Owner President
Phone
(605) 432-5730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SD491 SD Primary

Addresses

Primary practice location

411 S Main St
Milbank, SD 57252-2424

Mailing address

411 S Main St
PO Box 471
Milbank, SD 57252-2424
Phone (605) 432-5730

Other identifiers 2

IdentifierTypeStateIssuer
9202533MedicaidSD
358723100OtherMNMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040611000274 SD Part B Supplier - Clinic/Group Practice 2365425196 Receives reassigned benefits from 1 practitioner
Practice locations: Milbank, SD
O20100930022171 SD DME Supplier - Physician - OptometristDME Supplier - Optician 2365425196 Practice locations: Milbank, SD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Conroy Eye Care PC411 S Main St, Milbank, SD 57252-2424(605) 432-5730 Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2003

National Provider Directory

National Provider Directory
Tax ID family
Conroy Eye Care PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1063479426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S MAIN ST",
            "address_2": "PO BOX 471",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572522424",
            "telephone_number": "605-432-5730",
            "fax_number": "605-432-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S MAIN ST",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572522424",
            "telephone_number": "605-432-5730",
            "fax_number": "605-432-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROY EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "605-432-5730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "SD491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9202533",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "358723100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milbank, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.