Terra L Boettcher, OD
Individual provider Active NPI Optometrist · Grand Forks, ND
NPI 1124125901 · NPPES record last updated Mar 5, 2019
Key facts
- NPI
- 1124125901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 588 (ND)
- Practice address
- 4440 S Washington St - Altru Professional Center
Grand Forks, ND 58201 - Phone
- (701) 732-7000
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Dakota Eye Clinic LTD
Practice addresses (Care Compare)
1820 S 42ND St
Grand Forks, ND 58201-5712
Phone (701) 775-3151
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120210000421 | ND | Practitioner - Optometry | 4183881634 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Dakota Eye Clinic, LTD | Current |
Accepting new patients | |
| North Dakota Eye Clinic, LTD | Optometrist | Past |
Accepting new patients |
Locations
1820 S 42nd St
Grand Forks, ND 58201
Phone (701) 775-3151
Interoperability endpoints
- tboettcher@ndec.intellechartdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 588 | ND | Yes |
Addresses
Primary practice location
4440 S Washington St - Altru Professional Center
Grand Forks, ND 58201
Mailing address
2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891
Other providers in Grand Forks, ND
- Brendan McKay Boe
- Christopher T Boe
- Jamie J Boe
- Chad E Boen
- Kari Elizabeth Boese
- Jodi R Boettner
- Estella Ann Boger
- Ashlei Bogert
- Kayla Mae Bolden
- Julie Anne Bolduc
All providers in Grand Forks, ND · Optometrist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.