Individual provider Active NPI

Mitchel Ibach, O.D.

  • Optometrist
  • Sioux Falls, SD
National Provider Identifier
1184934069
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
709 Issued in SD
Practice address
3101 W 57TH St
Sioux Falls, SD 57108-3162
Phone
(605) 361-3937
Fax
(605) 371-7199
NPI assigned
Oct 13, 2010
Last updated
Apr 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 709 SD Primary

Addresses

Primary practice location

3101 W 57TH St
Sioux Falls, SD 57108-3162

Mailing address

3101 W 57TH St
Sioux Falls, SD 57108-3162
Phone (605) 361-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20140925000015 SD Practitioner - Optometry 8527200435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3101 W 57TH St
Sioux Falls, SD 57108-3162
Phone (605) 371-7100

Merit-based Incentive Payment System (MIPS)

Final score
95.53 of 100Reported as individual
Quality
91.88
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vance Thompson Vision Clinic Prof LLC Optometrist CurrentSince Sep 1, 2014 Accepting new patients

Locations

3101 W 57th St
Sioux Falls, SD 57108
Phone (605) 361-3937

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": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1184934069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571083162",
            "telephone_number": "605-361-3937",
            "fax_number": "605-371-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571083162",
            "telephone_number": "605-361-3937",
            "fax_number": "605-371-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBACH",
        "first_name": "MITCHEL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.