Active NPI
Amy M Mitzel Dubois, OD
- Optometrist
- Fargo, ND
National Provider Identifier
1144275702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 572
- Practice address
- 3232 13TH Ave S
Fargo, ND 58103 - Phone
- (701) 280-3000
- Fax
- (701) 280-1304
- NPI assigned
- May 23, 2006
- Last updated
- Aug 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 572 | ND | Primary |
Addresses
Primary practice location
3232 13TH Ave S
Fargo, ND 58103
Mailing address
3232 13TH Ave S
Fargo, ND 58103
Phone (701) 280-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3232 13TH Ave S
Fargo, ND 58103-3403
Phone (701) 280-3000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 46 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 572 | ND | MD | Speech-Language Pathologist |
Organizations & group practices 1
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": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282867200000",
"number": "1144275702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3232 13TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "58103",
"telephone_number": "701-280-3000",
"fax_number": "701-280-1304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3232 13TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "58103",
"telephone_number": "701-280-3000",
"fax_number": "701-280-1304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITZEL DUBOIS",
"first_name": "AMY",
"middle_name": "M",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2010-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ND",
"license": "572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.