Individual provider Active NPI

Benjamin Clark Seljestad, O.D.

  • Optometrist
  • Carson City, NV
National Provider Identifier
1124297148
Registry record updated Feb 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
490 Issued in NV
Practice address
700 Old Clear Creek Rd
Carson City, NV 89705-6853
Phone
(775) 884-2020
NPI assigned
Feb 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 490 NV Primary

Addresses

Primary practice location

700 Old Clear Creek Rd
Carson City, NV 89705-6853

Mailing address

700 Old Clear Creek Rd
Carson City, NV 89705-6853
Phone (775) 884-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20040325001121 NV Practitioner - Optometry 1153210737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Sierra Eyecare IncGroup PAC ID 7012982242, 2 clinicians

Practice addresses (Care Compare)

3033 N Carson St
Carson City, NV 89706-0153
Phone (775) 884-2020

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Sierra Eyecare, Inc. Optometrist CurrentSince Jul 1, 2004 Accepting new patients
Optic One Eye Care Centers of Spokane PC Optometrist PastSince Nov 1, 2002 Accepting new patients
See Center Optometrist PastSince Jul 15, 2019 Accepting new patients

Locations

700 Old Clear Creek Rd
Carson City, NV 89705
Phone (775) 881-2502

3033 N Carson St
Carson City, NV 89706
Phone (775) 884-2020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1203724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203724800000",
    "number": "1124297148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLD CLEAR CREEK RD",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897056853",
            "telephone_number": "775-884-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLD CLEAR CREEK RD",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897056853",
            "telephone_number": "775-884-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELJESTAD",
        "first_name": "BENJAMIN",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-23",
        "last_updated": "2008-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.