Individual provider Active NPI

Marc William Harrie, O.D.

  • Optometrist
  • Bloomington, MN
National Provider Identifier
1427502749
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3469 Issued in MN
Practice address
9117 Lyndale Ave S
Bloomington, MN 55420-3522
Phone
(952) 835-1235
Fax
(952) 224-0391
NPI assigned
Aug 4, 2016
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3469 MN Primary

Addresses

Primary practice location

9117 Lyndale Ave S
Bloomington, MN 55420-3522

Mailing address

9117 Lyndale Ave S
Bloomington, MN 55420-3522
Phone (952) 835-1235

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
I20160914000961 MN Practitioner - Optometry 6901192145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1244 Washington Ave
Detroit Lakes, MN 56501-3906
Phone (218) 847-2020

Merit-based Incentive Payment System (MIPS)

Final score
77.71 of 100Reported as group
Quality
53.86
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Eye Care Optometrists, P.a. Optometrist Current Accepting new patients
Morrison Eye Care Optometrists, P.a. Optometrist CurrentSince Jun 8, 2020 Accepting new patients
Lance K Bergstrom MD, PC Optometrist PastSince Jun 8, 2020 Accepting new patients

Locations

1244 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 847-0395

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, 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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1427502749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9117 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203522",
            "telephone_number": "952-835-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9117 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203522",
            "telephone_number": "952-835-1235",
            "fax_number": "952-224-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIE",
        "first_name": "MARC",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.