Individual provider Active NPI

Niropa Prasad, O.D.

  • Optometrist
  • Fargo, ND
National Provider Identifier
1235288267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
484 Issued in ND
Practice address
3402 13TH Ave S
Suite D
Fargo, ND 58103
Phone
(701) 234-0939
Fax
(701) 234-9442
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 484 ND Primary

Addresses

Primary practice location

3402 13TH Ave S
Suite D
Fargo, ND 58103

Mailing address

3402 13TH Ave S
Suite D
Fargo, ND 58103
Phone (701) 234-0939

Other identifiers 2

IdentifierTypeStateIssuer
14202OtherNDBLUE SHIELD OF ND PIN
5C646PROtherMNBLUE SHIELD OF MN PIN

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
I20101110000035 ND Practitioner - Optometry 2365637832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific Medical College, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
3-D Optical IncGroup PAC ID 1951361732, 3 clinicians

Practice addresses (Care Compare)

3402 13TH Ave S
Fargo, ND 58103-6324
Phone (701) 234-0939

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
484NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
3-D Optical Inc Optometrist CurrentSince Aug 1, 1996 Accepting new patients
I C 20 20 Eau Claire Inc Optometrist PastSince Aug 1, 1996 Accepting new patients

Locations

3120 25th St SW
Ste X
Fargo, ND 58103
Phone (701) 234-9768

3402 13th Ave S
Ste E
Fargo, ND 58103
Phone (701) 234-0939

3402 13th Ave S
Ste D
Fargo, ND 58103
Phone (701) 234-0939

3402 13th Ave S
Fargo, ND 58103
Phone (701) 234-0939

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235288267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 13TH AVE S",
            "address_2": "SUITE D",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-234-0939",
            "fax_number": "701-234-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 13TH AVE S",
            "address_2": "SUITE D",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-234-0939",
            "fax_number": "701-234-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "NIROPA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ND PIN",
            "identifier": "14202",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MN PIN",
            "identifier": "5C646PR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.