Dwayne Robert Ice, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T-149 Issued in SD

Practice address

825 Columbus St
Ste E
Rapid City, SD 57701-4803

Phone

(605) 343-4703

Fax

(605) 721-7201

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

M. Scott Ellender, OD and Elizabeth a Ellender, OD, PCGroup PAC ID 5294717229, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• M. Scott Ellender, OD and Elizabeth a Ellender, OD, PC

  • Optometrist
  • Rapid City, SD
  • NPI 1568630085
  Medicare reassignment Care Compare group NPD
• Vision Source Rapid City

  • Optometrist
  • Rapid City, SD
  • NPI 1396342515
  NPD Authorized official
• John B. Jarding OD, LLC

  • Low Vision Rehabilitation Optometrist
  • Rapid City, SD
  • NPI 1528255924
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1447362074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 COLUMBUS ST",
            "address_2": "STE E",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014803",
            "telephone_number": "605-343-4703",
            "fax_number": "605-721-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 COLUMBUS ST",
            "address_2": "STE E",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014803",
            "telephone_number": "605-343-4703",
            "fax_number": "605-721-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICE",
        "first_name": "DWAYNE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "T-149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201450",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Raymond Huskey, D.D.S.
• Matthew Lee Hustrulid, MD
• Jessica L Hutchinson, CNP
• Michael Huxford, PSYD
• Emily Grace Hvezda
• Lindsay Ickler, QASP-S
• Independent Eyes LLC
• Independent Optical, Inc
• Indian Health Service
• Individual and Family Counseling

• Optometrist in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.