Individual provider Active NPI

Dessie Dee Mason, OD

  • Optometrist
  • Austin, MN
National Provider Identifier
1366000697
Registry record updated Oct 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3618 Issued in MN
Practice address
200 14TH St NW
Austin, MN 55912-4699
Phone
(507) 437-3227
NPI assigned
Jun 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3618 MN Primary

Addresses

Primary practice location

200 14TH St NW
Austin, MN 55912-4699

Mailing address

52185 320TH St
Blooming Prairie, MN 55917-8913
Phone (605) 280-5114

Other identifiers 1

IdentifierTypeStateIssuer
3618OtherMNLICENSE TO PRACTICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20190607001803 MN Practitioner - Optometry 8426381310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Care Center of Austin Inc.Group PAC ID 1456424365, 4 clinicians

Practice addresses (Care Compare)

200 14TH St NW
Austin, MN 55912-4699
Phone (507) 437-3227

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3618MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Care Center of Austin Inc. Optometrist CurrentSince Jun 3, 2019 Accepting new patients
Lifetime Eye Care of Rochester Inc Optometrist CurrentSince Jun 3, 2019 Accepting new patients
Jeffrey L. Anderson, O.D. Optometrist PastSince Jun 3, 2019 Accepting new patients

Locations

200 14th St NW
Austin, MN 55912
Phone (507) 437-3227

3632 10th Ln NW
Ste 2
Rochester, MN 55901
Phone (507) 282-7121

3632 10th Ln NW
Rochester, MN 55901
Phone (507) 281-5000

Organizations & group practices 3

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": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601683200000",
    "number": "1366000697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52185 320TH ST",
            "city": "BLOOMING PRAIRIE",
            "state": "MN",
            "postal_code": "559178913",
            "telephone_number": "605-280-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 14TH ST NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559124699",
            "telephone_number": "507-437-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "DESSIE",
        "middle_name": "DEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-02",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE TO PRACTICE",
            "identifier": "3618",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, MN

Sources for this page

Verify at the official NPI Registry.