Individual provider Active NPI

Nancy Lynn Hetland, O.D.

  • Optometrist
  • Mitchell, SD
National Provider Identifier
1659460889
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
1900 N Main St
Mitchell, SD 57301-1160
Phone
(605) 996-7042
Fax
(605) 996-6627
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

1900 N Main St
Mitchell, SD 57301-1160

Mailing address

2848 Dailey Dr
Mitchell, SD 57301-5209
Phone (605) 292-0648

Other identifiers 2

IdentifierTypeStateIssuer
IL-9397OtherILEYEMED PROVIDER NUMBER
0040030744OtherILBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070302000211 SD Practitioner - Optometry 2860594272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Central Eye IncGroup PAC ID 2668531534, 2 clinicians

Practice addresses (Care Compare)

1101 E Spruce St
Mitchell, SD 57301-4867
Phone (605) 995-1014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009397ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Eye, Inc. CurrentSince May 1, 2019 Accepting new patients

Locations

1101 E Spruce St
Mitchell, SD 57301
Phone (605) 995-1014

3700 S Grange Ave
Sioux Falls, SD 57105
Phone (605) 988-9150

3209 S Louise Ave
Sioux Falls, SD 57106
Phone (605) 362-1602

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659460889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 DAILEY DR",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573015209",
            "telephone_number": "605-292-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N MAIN ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011160",
            "telephone_number": "605-996-7042",
            "fax_number": "605-996-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETLAND",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED PROVIDER NUMBER",
            "identifier": "IL-9397",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0040030744",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.