Mark Struble, OD
Individual provider Active NPI Optometrist · Wagner, SD
NPI 1477575827 · NPPES record last updated Nov 30, 2007
Key facts
- NPI
- 1477575827
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 582 (SD)
- Practice address
- 121 S Main Ave
Wagner, SD 57380 - Phone
- (605) 384-3565
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vision Care Associates LLP
Practice addresses (Care Compare)
701 Main St
Britton, SD 57430-3053
Phone (605) 448-5151
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.73 of 100
- Quality
- 85.15
- Promoting interoperability
- 73
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100622000724 | SD | Practitioner - Optometry | 3971607524 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 582 | SD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Care Associates, LLP | Optometrist | Current |
Accepting new patients |
Locations
310 8th Ave NW
Ste 503
Aberdeen, SD 57401
Phone (605) 225-2020
310 8th Ave NW
Aberdeen, SD 57401
Phone (605) 225-2020
300 W 5th St
Miller, SD 57362
Phone (605) 853-0158
121 S Main Ave
Wagner, SD 57380
Phone (605) 384-3565
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 582 | SD | Yes |
Addresses
Primary practice location
121 S Main Ave
Wagner, SD 57380
Mailing address
310 8TH Ave NW Ste 503
Aberdeen, SD 57401-2369
Phone (605) 225-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9202017 | Medicaid | SD |
Other providers in Wagner, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.