Elaine Victoria Petry, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

785 Issued in SD

Practice address

1236 North Ave
Spearfish, SD 57783-1533

Phone

(605) 642-2645

NPI assigned

Apr 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Mountain Valley Vision CenterGroup PAC ID 3072772847, 2 clinicians

Slingsby and Huot Eye Associates ProfGroup PAC ID 3476806530, 7 clinicians

Deadwood Eye Care LLCGroup PAC ID 2567615917, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mountain Valley Vision Center

  • Optometrist
  • Spearfish, SD
  • NPI 1932479474
  Medicare reassignment Care Compare group NPD
• Deadwood Eye Care LLC

  • Optometrist
  • Deadwood, SD
  • NPI 1003168980
  Medicare reassignment Care Compare group
• Slingsby & Huot Eye Associates Prof

  • Ophthalmology Physician
  • Rapid City, SD
  • NPI 1962901561
  Care Compare group
• Michael J Guilbert, OD, PC

  • Optometrist
  • Deadwood, SD
  • NPI 1932288131
  NPD (past)

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1083296669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N GRAND AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647017",
            "telephone_number": "918-444-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 NORTH AVE",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831533",
            "telephone_number": "605-642-2645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "88 Charles St",
            "address_purpose": "LOCATION",
            "city": "Deadwood",
            "state": "SD",
            "postal_code": "577321303",
            "country_code": "US",
            "telephone_number": "605-578-1761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRY",
        "first_name": "ELAINE",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Peldo, CCC-SLP
• Piper A Perez, BS
• Performance Physical Therapy Prof
• Donna L. Peters, C.N.P.
• Taira Peterson
• Rachel Pettersen, LPC-MH, QMHP
• Natalie Louise Polei, RD
• Ponderosa Apartments, Inc
• Alicia Porsch, DPT
• Potter Counseling LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.