Individual provider Active NPI

John Allen Conroy, OD

  • Optometrist
  • Milbank, SD
National Provider Identifier
1144219213
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SD491 Issued in SD
Practice address
411 S Main St
Milbank, SD 57252-2424
Phone
(605) 432-5730
Fax
(605) 432-4324
NPI assigned
Oct 20, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SD491 SD Primary
Optometrist 152W00000X 2118 MN

Addresses

Primary practice location

411 S Main St
Milbank, SD 57252-2424

Mailing address

411 S Main St
Milbank, SD 57252-2424
Phone (605) 432-5730

Other identifiers 4

IdentifierTypeStateIssuer
358723100MedicaidMN
4645120001OtherMNDMERC
4645120002OtherSDDMERC
9202533MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090114000222 MN Practitioner - Optometry 7719040971 Reassigns benefits to 1 organization
I20101006000775 SD Practitioner - Optometry 7719040971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1011 Broadway
Wheaton, MN 56296-1303
Phone (320) 563-4610

411 S Main St
Milbank, SD 57252-2424
Phone (605) 432-5730

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2118MNMDClinical Psychologist
491SDMDClinical Child & Adolescent Psychologist
SD491SDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Conroy Eye Care PC Optometrist CurrentSince Jan 1, 2003 Accepting new patients
Conroy Eye Care PC Optometrist CurrentSince Jan 1, 2003 Accepting new patients
Ophthalmology Associates 010196 PastSince Jan 1, 2003 Accepting new patients

Locations

1011 Broadway
Wheaton, MN 56296
Phone (320) 563-4610

411 S Main St
Milbank, SD 57252
Phone (605) 432-5730

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144219213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S MAIN ST",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572522424",
            "telephone_number": "605-432-5730",
            "fax_number": "605-432-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S MAIN ST",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572522424",
            "telephone_number": "605-432-5730",
            "fax_number": "605-432-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "SD491",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2118",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358723100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4645120001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4645120002",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9202533",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milbank, SD

Sources for this page

Verify at the official NPI Registry.