Individual provider Active NPI

Angela R. Gulbranson, O.D.

  • Optometrist
  • Sioux Falls, SD
National Provider Identifier
1417040452
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
565 Issued in SD
Practice address
6201 S. Minnesota Ave
Sioux Falls, SD 57108-2559
Phone
(605) 274-6717
Fax
(605) 275-4804
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 565 SD Primary

Addresses

Primary practice location

6201 S. Minnesota Ave
Sioux Falls, SD 57108-2559

Mailing address

6201 S. Minnesota Ave
Sioux Falls, SD 57108-2559
Phone (605) 274-6717

Other identifiers 2

IdentifierTypeStateIssuer
9203264MedicaidSD
9203263MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20041018000158 SD Practitioner - Optometry 4688634736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Angela R. Gulbranson, OD PCGroup PAC ID 9830159979, 4 clinicians

Practice addresses (Care Compare)

6144 S Lyncrest Ave
Sioux Falls, SD 57108-2560
Phone (605) 271-7100

6201 S Minnesota Ave
Sioux Falls, SD 57108-2559
Phone (605) 274-6717

6205 S Minnesota Ave
Sioux Falls, SD 57108-2559
Phone (605) 274-6717

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Angela R. Gulbranson, OD, PC Optometrist CurrentSince Aug 12, 2004 Accepting new patients
Angela R. Gulbranson OD, PC CurrentSince Feb 11, 2003 Accepting new patients

Locations

6205 S Minnesota Ave
Sioux Falls, SD 57108
Phone (605) 271-7100

106 W 69th St
Sioux Falls, SD 57108
Phone (605) 274-6717

6144 S Lyncrest Ave
Sioux Falls, SD 57108
Phone (605) 271-7100

6201 S Minnesota Ave
Sioux Falls, SD 57108
Phone (605) 274-6717

Organizations & group practices 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1417040452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 S. MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082559",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 S. MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082559",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULBRANSON",
        "first_name": "ANGELA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203264",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203263",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.