Kristin F Engstrom, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

582 Issued in ND

Practice address

4731 13TH Ave S
Fargo, ND 58103-7205

Phone

(701) 281-2746

Fax

(701) 281-2747

NPI assigned

Sep 15, 2006

Last updated

Sep 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kristin F Miller Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kristin F Engstrom O D PCGroup PAC ID 0244228724, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kristin F Engstrom, O.D. PC

  • Optometrist
  • Fargo, ND
  • NPI 1972609303
  Medicare reassignment Care Compare group NPD Authorized official
• Kristin F Engstrom, O.D. PC

  dba Dr. Engstrom and Associates

  • Optometrist
  • Fargo, ND
  • NPI 1073840336
  NPD Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1154427565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 TIMBERLINE DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-730-6168",
            "fax_number": "701-281-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037205",
            "telephone_number": "701-281-2746",
            "fax_number": "701-281-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGSTROM",
        "first_name": "KRISTIN",
        "middle_name": "F",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "582",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2512",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60597",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "MILLER",
            "middle_name": "F",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel England
• Bailey Englerth
• Samantha English
• Jamison David Englund, D.C.
• James William Engstrom, O.D.
• Scott A Engum, MD
• Fomben Esabella Enjei Achu
• James Duane Enkers, PHARMACIST
• Enlift Health Medical Clinic PLLC
• Paula Renee Ennis

• Optometrist in Fargo, ND
• Providers in Fargo, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.

Verify at the official NPI Registry.