Jon C Kolstad, OD PC
Individual provider Active NPI Optometrist · Glasgow, MT
NPI 1679620587 · NPPES record last updated Apr 15, 2014
Key facts
- NPI
- 1679620587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 616 (MT)
- Practice address
- 630 3Rd Ave S
Glasgow, MT 59230-2407 - Phone
- (406) 228-8641
- Fax
- (406) 228-2094
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Other NPIs with the same Medicare PAC ID 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
630 3Rd Ave S
The Eye Clinic
Glasgow, MT 59230-2407
Phone (406) 228-8641
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 53 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MT
- 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 |
|---|---|---|---|---|
| I20120412000778 | MT | Practitioner - Optometry | 7719979988 | Reassigns benefits to 1 organization |
| O20100930069965 | MT | DME Supplier - Physician - Optometrist | 1951393123 | Practice locations: Glasgow, MT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jon Kolstad O D, P C | Optometrist | Current |
Accepting new patients |
| Jon C Kolstad OD, PC | Optometrist | Current | Accepting new patients |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
630 3rd Ave S
Glasgow, MT 59230
Phone (406) 228-8641
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 616 | MT | Yes |
Addresses
Primary practice location
630 3Rd Ave S
Glasgow, MT 59230-2407
Mailing address
630 3Rd Ave S
Glasgow, MT 59230-2407
Phone (406) 228-8641
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000480012 | Medicaid | MT | |
| 0000482647 | Medicaid | MT | |
| 0000483565 | Medicaid | MT |
Other providers in Glasgow, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2014. 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.