Amanda Marie Mackner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

799 Issued in ND

Practice address

4360 13TH Ave S
Fargo, ND 58103-3310

Phone

(701) 282-5880

NPI assigned

Jul 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Amanda Marie Hanson Former name

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

Pacific University - College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Eyes PLLCGroup PAC ID 5496015091, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• All Eyes PLLC

  • Optometrist
  • Shakopee, MN
  • NPI 1053557256
  Medicare reassignment Care Compare group NPD
• Hadden Eyecare Associates

  • Optometrist
  • Bloomington, MN
  • NPI 1992991426
  Medicare reassignment NPD
• West Fargo Eyecare Associates PC

  • Optometrist
  • West Fargo, ND
  • NPI 1871031153
  NPD (past)

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1386216885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033310",
            "telephone_number": "701-282-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033310",
            "telephone_number": "701-282-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKNER",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "2935",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3852-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3730",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HANSON",
            "middle_name": "MARIE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jon A. Machayya, MD
• Janet Elaine Macheledt, MD
• Leslie Rae Mack, LPC MS NCC
• Rachel Anne Mack, CNP
• Robert D Mack, DDS
• Nicholas Mackner
• Sherie Kay Madewell-Buesgens, LCSW
• Hussein Abuker Madey
• Srinivasa Raghavan Madhavan, M.D.
• John Charles Madison III, MD

• Optometrist in Fargo, ND
• Providers in Fargo, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.