Advanced Eyecare
Organization Active NPI Optometrist · Grand Forks, ND
NPI 1134463565 · NPPES record last updated May 21, 2021
Key facts
- NPI
- 1134463565
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 538 (ND)
- Legal business name
- ADVANCED EYECARE
- Practice address
- 1401 28TH Ave S
Grand Forks, ND 58201-6731 - Phone
- (701) 757-2121
- Fax
- (701) 757-2120
- NPI assigned
- Nov 26, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Julie Ann Lagodinski, OD
- Title
- Optometrist
- Phone
- (701) 757-2121
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130529000959 | ND | Part B Supplier - Clinic/Group Practice | 8729226923 |
Receives reassigned benefits from 1 practitioner Practice locations: Grand Forks, ND |
National Provider Directory
Locations
1401 28th Ave S
Grand Forks, ND 58201
Phone (701) 757-2121
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 538 | ND | Yes |
Addresses
Primary practice location
1401 28TH Ave S
Grand Forks, ND 58201-6731
Mailing address
1401 28TH Ave S
Grand Forks, ND 58201-6731
Phone (701) 757-2121
Other providers in Grand Forks, ND
- Mohammad Amin Adie
- Gloria A Adjekum
- Kenneth Aduba
- Advance Chiropractic Center PLLC
- Advance Chiropractic Clinic, P.C.
- Advanced Looks Eye Care PC
- Akossiwa Afawubo
- Agassiz Associates, PLLC
- Aging in Place Home Care, LLC
- Agio Roba Inc.
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 May 21, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.