Individual provider Active NPI

Dean Albin Ver Mulm, OD

  • Optometrist
  • Emmetsburg, IA
National Provider Identifier
1427037787
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02022 Issued in IA
Practice address
804 Broadway
Emmetsburg, IA 50536
Phone
(712) 852-4123
Fax
(712) 852-4864
NPI assigned
Jan 13, 2006
Last updated
Nov 29, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02022 IA Primary

Addresses

Primary practice location

804 Broadway
Emmetsburg, IA 50536

Mailing address

PO Box 416
804 Broadway
Emmetsburg, IA 50536-0416
Phone (712) 852-4123

Other identifiers 1

IdentifierTypeStateIssuer
0100768MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20041122000747 IA Practitioner - Optometry 7810952587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

804 Broadway St
Emmetsburg, IA 50536-2422
Phone (712) 852-4123

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as individual
Quality
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02022IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Ver Mulm, OD PC Optometrist CurrentSince Aug 16, 1993 Accepting new patients
Wolfe Clinic Inc PastSince Dec 1, 2012 Accepting new patients

Locations

804 Broadway St
Emmetsburg, IA 50536
Phone (712) 852-4123

804 Broadway St
#416
Emmetsburg, IA 50536
Phone (712) 852-4123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1427037787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416",
            "address_2": "804 BROADWAY",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505360416",
            "telephone_number": "712-852-4123",
            "fax_number": "712-852-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 BROADWAY",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "50536",
            "telephone_number": "712-852-4123",
            "fax_number": "712-852-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VER MULM",
        "first_name": "DEAN",
        "middle_name": "ALBIN",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100768",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmetsburg, IA

Sources for this page

Verify at the official NPI Registry.