Stacey Archibald, B.SC., O.D.
Individual provider Active NPI Optometrist · Fargo, ND
NPI 1306139266 · NPPES record last updated Sep 13, 2018
Key facts
- NPI
- 1306139266
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 689 (ND)
- Practice address
- 3409 45TH St S Ste 100
Fargo, ND 58104-8970 - Phone
- (701) 561-0086
- Fax
- (701) 561-0087
- NPI assigned
- May 25, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Waterloo - School of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3409 45TH St S
Suite 100
Fargo, ND 58104-4591
Phone (701) 561-0086
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110816000094 | ND | Practitioner - Optometry | 2365611985 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Focus Vision Development Center LLC | Current | Accepting new patients | |
| S Archibald OD PC | Optometrist | Current |
Accepting new patients |
| Eyes on Broadway LLC | Optometrist | Past | Accepting new patients |
Locations
3409 45th St S
Ste 100
Fargo, ND 58104
Phone (701) 277-3636
3902 13th Ave S
Ste 256
Fargo, ND 58103
Phone (701) 277-3636
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 689 | ND | Yes |
Addresses
Primary practice location
3409 45TH St S Ste 100
Fargo, ND 58104-8970
Mailing address
3409 45TH St S Ste 100
Fargo, ND 58104-8970
Phone (701) 561-0086
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.