Dori M. Carlson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

494 Issued in ND

Practice address

121 Briggs Ave N
Park River, ND 58270-0714

Phone

(701) 284-7330

Fax

(701) 284-7332

NPI assigned

Mar 31, 2006

Last updated

Apr 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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 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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1989

Medicare assignment

May accept Medicare assignment

Group practices

Heartland Eye Care, PCGroup PAC ID 2466442041, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.27 of 100Reported as group

Quality

92.54

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dori.carlson@direct.revolutionehr.com

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.

• Heartland Eye Care, PC

  • Optometrist
  • Park River, ND
  • NPI 1932277936
  Medicare reassignment Care Compare group NPD Authorized official
• Heartland Eye Care, P.C.

  • Optometrist
  • Grafton, ND
  • NPI 1518026046
  NPD Authorized official

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1649231192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX O",
            "address_2": "121 BRIGGS AVE N",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "582700714",
            "telephone_number": "701-284-7330",
            "fax_number": "701-284-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BRIGGS AVE N",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "582700714",
            "telephone_number": "701-284-7330",
            "fax_number": "701-284-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "DORI",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60418",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Bata, LRD
• Allie Beneda, PTA
• Nicholas Dennis Beneda, DDS
• Gretchen Marie Brummond, DDS
• Micheala Burling
• Christian Unity Hospital Corporation (Park River Family Clinic)
• Tamara J Clemetson, PA-C
• Daniel James Degree, PHARM.D.
• Paul Benedict Dusek, DDS
• Roberta L Ekman, DENTIST

• Optometrist in Park River, ND
• Providers in Park River, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.