Individual provider Active NPI

Glen T Cahill, O.D.

  • Optometrist
  • Belcourt, ND
National Provider Identifier
1265402267
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1342-3 Issued in KS
Practice address
1300 Hospital Road
Belcourt, ND 58316
Phone
(701) 477-6111
Fax
(701) 477-2507
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1342-3 KS Primary

Addresses

Primary practice location

1300 Hospital Road
Belcourt, ND 58316

Mailing address

1300 Hospital Road
Belcourt, ND 58316
Phone (701) 477-6111

Other identifiers 1

IdentifierTypeStateIssuer
60712MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120328000204 TX Practitioner - Optometry 9638118359

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
42.91 of 100Reported as group
Quality
5.54
Improvement activities
40
Cost
66.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1342-3KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin N Burdick Comprehensive Health Care Facility PastSince Feb 2, 2012 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1265402267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL ROAD",
            "city": "BELCOURT",
            "state": "ND",
            "postal_code": "58316",
            "telephone_number": "701-477-6111",
            "fax_number": "701-477-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL ROAD",
            "city": "BELCOURT",
            "state": "ND",
            "postal_code": "58316",
            "telephone_number": "701-477-6111",
            "fax_number": "701-477-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHILL",
        "first_name": "GLEN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1342-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60712",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belcourt, ND

Sources for this page

Verify at the official NPI Registry.