Individual provider Active NPI

Jed Dunham Hillmer, O.D.

  • Optometrist
  • Fargo, ND
National Provider Identifier
1174622245
Registry record updated Feb 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
670 Issued in ND
Practice address
101 10TH St N
Suite 120
Fargo, ND 58102-4600
Phone
(701) 239-9771
Fax
(701) 293-0944
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3051 MN
Optometrist 152W00000X 670 ND Primary

Addresses

Primary practice location

101 10TH St N
Suite 120
Fargo, ND 58102-4600

Mailing address

101 10TH St N
Suite 120
Fargo, ND 58102-4600
Phone (701) 239-9771

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081223000039 ND Practitioner - Optometry 7911903166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 10TH St N
Suite 120
Fargo, ND 58102-4600
Phone (701) 239-9771

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
670NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jed D Hillmer OD PLLC Optometrist CurrentSince Dec 20, 2010 Accepting new patients
Gary L. Renier, O.D. LTD Optometrist PastSince Jan 1, 2011 Accepting new patients
Visionworks, Inc. Optometrist Past Accepting new patients
Visionworks Inc Past Accepting new patients

Locations

101 10th St N
Ste 120
Fargo, ND 58102
Phone (701) 239-9771

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298764800000",
    "number": "1174622245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 10TH ST N",
            "address_2": "SUITE 120",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024600",
            "telephone_number": "701-239-9771",
            "fax_number": "701-293-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 10TH ST N",
            "address_2": "SUITE 120",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024600",
            "telephone_number": "701-239-9771",
            "fax_number": "701-293-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLMER",
        "first_name": "JED",
        "middle_name": "DUNHAM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3051",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.