Individual provider Active NPI

Branden L Perzinski, O.D.

  • Optometrist
  • Fargo, ND
National Provider Identifier
1588829485
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
664 Issued in ND
Practice address
4731 13TH Ave S
Fargo, ND 58103-7269
Phone
(701) 281-2746
NPI assigned
Jul 21, 2008
Last updated
Jul 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 664 ND Primary

Addresses

Primary practice location

4731 13TH Ave S
Fargo, ND 58103-7269

Mailing address

4788 48TH Ave S
Fargo, ND 58104-6040
Phone (503) 347-6948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20081120000586 ND Practitioner - Optometry 4880754878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kristin F Engstrom O D PCGroup PAC ID 0244228724, 2 clinicians

Practice addresses (Care Compare)

4731 13TH Ave SW
Fargo, ND 58103-7205
Phone (701) 281-2746

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kristin F Engstrom, O.D. PC Optometrist CurrentSince Nov 4, 2008 Accepting new patients
Kristin F Engstrom, O.D. PC Optometrist CurrentSince Nov 4, 2008 Accepting new patients

Locations

4731 13th Ave S
Fargo, ND 58103
Phone (701) 281-2746

4731 13th Ave S
Ste 1
Fargo, ND 58103

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1588829485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4788 48TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046040",
            "telephone_number": "503-347-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037269",
            "telephone_number": "701-281-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERZINSKI",
        "first_name": "BRANDEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.