NPIMap

Organization Active NPI

Miles City Vision Clinic P C

  • Optometrist
  • Miles City, MT
National Provider Identifier
1215006416
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
500 Issued in MT
Legal business name
MILES CITY VISION CLINIC P C
Practice address
1909 Main St
Miles City, MT 59301-3724
Phone
(406) 234-7426
Fax
(406) 234-7005
NPI assigned
Nov 6, 2006
Last updated
Feb 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Authorized official

Name
Dr. Robert Dean Lunde, O DNPI 1427023522
Title
Owner
Phone
(406) 234-7426

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 500 MT Primary

Addresses

Primary practice location

1909 Main St
Miles City, MT 59301-3724

Mailing address

1909 Main St
Miles City, MT 59301-3724
Phone (406) 234-7426

Other identifiers 3

IdentifierTypeStateIssuer
0482807MedicaidMT
0481546MedicaidMT
0481039MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031223000808 MT Part B Supplier - Clinic/Group Practice 3476451717 Receives reassigned benefits from 1 practitioner
Practice locations: Miles City, MT
O20100930084957 MT DME Supplier - Physician - OptometristDME Supplier - Optician 3476451717 Practice locations: Miles City, MT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Miles City Vision Clinic PC1909 Main St, Miles City, MT 59301-3724(406) 234-7426 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1999

National Provider Directory

National Provider Directory
Tax ID family
Miles City Vision Clinic PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1215006416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 MAIN ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593013724",
            "telephone_number": "406-234-7426",
            "fax_number": "406-234-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 MAIN ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593013724",
            "telephone_number": "406-234-7426",
            "fax_number": "406-234-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILES CITY VISION CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "LUNDE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-234-7426",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0482807",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481546",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481039",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miles City, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.