Mila Jacoba Heersink Dovich, MD

Key facts

NPI

1679707665

Entity type

Individual (NPI type 1)

Primary specialty

Ophthalmology Physician 207W00000X

License

69417 (MN)

Practice address

8401 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4488

Phone

(763) 416-7600

Fax

(763) 416-7634

NPI assigned

May 6, 2009

Sex

Female

Sole proprietor

No

Organizations & group practices 4

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.

• Northwest Eye Clinic, LLC Ophthalmology Physician · Golden Valley, MN · NPI 1497837306
  Medicare reassignment Care Compare group NPD (past) MN · OPHTHALMOLOGY
• Northwest Eye Clinic, LLC Ophthalmology Physician · St. Anthony, MN · NPI 1255417002
  NPD OPHTHALMOLOGY
• Northwest Eye Clinic, LLC Ophthalmology Physician · Golden Valley, MN · NPI 1992044432
  NPD OPHTHALMOLOGY
• Weoc ER Inc Ophthalmology Physician · Philadelphia, PA · NPI 1194953760
  NPD (past) OPHTHALMOLOGY

Medicare Care Compare profile

Specialty

Ophthalmology

Education

University of Alabama School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Eye Clinic LLC (17 clinicians)

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.82 of 100 (group)

Quality

80.89

Promoting interoperability

94

Improvement activities

40

Cost

70.18

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Mila Jacoba Heersink Professional name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 30, 2021.

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1679707665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S STE 425",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313873",
            "telephone_number": "952-567-6125",
            "fax_number": "952-567-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD STE 100",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274488",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Walnut St",
            "address_2": "Suite 920",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075109",
            "country_code": "US",
            "telephone_number": "484-434-2700",
            "fax_number": "484-434-2793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 N 13th Ave",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864904",
            "country_code": "US",
            "telephone_number": "909-982-8846",
            "fax_number": "909-949-3967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEERSINK DOVICH",
        "first_name": "MILA",
        "middle_name": "JACOBA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A129482",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "69417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILA",
            "last_name": "HEERSINK",
            "middle_name": "JACOBA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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All providers in Golden Valley, MN · Ophthalmology Physician in Minnesota