Active NPI
Milbank Eyecare Center, Prof. L.L.C.
- Optometrist
- Milbank, SD
National Provider Identifier
1578747143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 583
- Legal business name
- MILBANK EYECARE CENTER, PROF. L.L.C.
- Practice address
- 224 S Main St
Milbank, SD 57252-1809 - Phone
- (605) 432-6666
- Fax
- (605) 432-9255
- NPI assigned
- Dec 19, 2007
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Dr. Nicholas R Gilmore, O.D.
- Title
- Owner
- Phone
- (605) 432-6666
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Milbank, SD
- NPI 1124079223
-
- Optometrist
- Edina, MN
- NPI 1710953161
-
- Optometrist
- Wasilla, AK
- NPI 1982604591
NPD (past) OPTOMETRIST
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 43D2078031 | Milbank Eyecare Center | Certificate of waiver | May 19, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Milbank Eyecare Center Prof LLC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080229000096 | SD | Part B Supplier - Clinic/Group Practice | 6608950688 |
Receives reassigned benefits from 2 practitioners Practice locations: Milbank, SD |
| O20100930020494 | SD | DME Supplier - Physician - Optometrist |
6608950688 | Practice locations: Milbank, SD |
National Provider Directory
Locations
224 S Main St
Milbank, SD 57252
Phone (605) 432-6666
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 583 | SD | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
224 S Main St
Milbank, SD 57252-1809
Mailing address
224 S Main St
Milbank, SD 57252-1809
Phone (605) 432-6666
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2013.
{
"created_epoch": "1198022400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1375315200000",
"number": "1578747143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 S MAIN ST",
"city": "MILBANK",
"state": "SD",
"postal_code": "572521809",
"telephone_number": "605-432-6666",
"fax_number": "605-432-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 S MAIN ST",
"city": "MILBANK",
"state": "SD",
"postal_code": "572521809",
"telephone_number": "605-432-6666",
"fax_number": "605-432-9255"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MILBANK EYECARE CENTER, PROF. L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-19",
"last_updated": "2013-08-01",
"status": "A",
"authorized_official_last_name": "GILMORE",
"authorized_official_first_name": "NICHOLAS",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "605-432-6666",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "SD",
"license": "583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Milbank, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.