Alicia M Archibald Swanson, OD
Individual provider Active NPI Optometrist · Brainerd, MN
NPI 1134583446 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1134583446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3507 (MN)
- Practice address
- 506 Laurel St
Brainerd, MN 56401-3526 - Phone
- (218) 829-0946
- Fax
- (218) 829-1279
- NPI assigned
- Apr 12, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brainerd Eyecare Center, PA
Practice addresses (Care Compare)
506 Laurel St
Brainerd, MN 56401-3526
Phone (218) 829-0946
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 46 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20170612002597 | MN | Practitioner - Optometry | 4981972197 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brainerd Eyecare Center, PA | Optometrist | Current |
Accepting new patients |
| Brainerd Eyecare Center, PA | Optometrist | Past |
Accepting new patients |
Locations
506 Laurel St
Brainerd, MN 56401
Phone (218) 829-0946
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3507 | MN | Yes |
Addresses
Primary practice location
506 Laurel St
Brainerd, MN 56401-3526
Mailing address
506 Laurel St
Brainerd, MN 56401
Phone (218) 829-0946
Other providers in Brainerd, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.