Steven Phillip Gander, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2128 Issued in MN

Practice address

421 Demers Ave. NW
East Grand Forks, MN 56721

Phone

(218) 773-3438

Fax

(218) 773-1645

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forks Optometric LTDGroup PAC ID 2567365794, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EFDABA

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.

• Forks Optometric, LTD.

  • Optometrist
  • East Grand Forks, MN
  • NPI 1144357211
  Medicare reassignment Care Compare group NPD
• Forks Optometric, LTD.

  • Eyewear Supplier
  • Crookston, MN
  • NPI 1942578562

  Optometrist

  NPD
• Minnesota Epilepsy Group PA

  • Neurology Physician
  • Roseville, MN
  • NPI 1932118056
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376639476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 8TH ST. SE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "56721",
            "telephone_number": "218-773-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 DEMERS AVE. NW",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "56721",
            "telephone_number": "218-773-3438",
            "fax_number": "218-773-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDER",
        "first_name": "STEVEN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2128",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "458",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60457",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Erickson, DPT
• Merit FL Fondong, NP
• Forks Optometric, LTD.
• Hannah Stephanie Fundaun, PHARMD
• Cathy A Galstad, MS CCC/SLP
• Mridu Gandhi, MD
• Harriet J Gibbons, PA-C
• Kaitlyn Sundby Glogoza, DMD
• Dorothy Gomez
• Mathew T Grasser, PT

• Optometrist in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.