Individual provider Active NPI

Jennifer A. Hupke, O.D.

  • Optometrist
  • Tea, SD
National Provider Identifier
1699723387
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
593 Issued in SD
Practice address
6201 S. Minnesota Ave
Tea, SD 57108-2559
Phone
(605) 274-6717
Fax
(605) 275-4804
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0593 SD
Optometrist 152W00000X 593 SD Primary

Addresses

Primary practice location

6201 S. Minnesota Ave
Tea, SD 57108-2559

Mailing address

6201 S. Minnesota Ave
Tea, SD 57108-2559
Phone (605) 274-6717

Other identifiers 7

IdentifierTypeStateIssuer
0040692OtherSDBLUE CROSS BLUE SHIELD
9201722MedicaidSD
SD0593OtherSDEYEMED
9201723MedicaidSD
30671OtherSDSIOUX VALLEY HEALTH PLAN
9201724MedicaidSD
9212280OtherSDDAKOTA CARE

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
I20040317000759 SD Practitioner - Optometry 4789574427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Angela R. Gulbranson, OD PCGroup PAC ID 9830159979, 4 clinicians

Practice addresses (Care Compare)

6144 S Lyncrest Ave
Sioux Falls, SD 57108-2560
Phone (605) 271-7100

6201 S Minnesota Ave
Sioux Falls, SD 57108-2559
Phone (605) 274-6717

6205 S Minnesota Ave
Sioux Falls, SD 57108-2559
Phone (605) 274-6717

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0593SDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Angela R. Gulbranson OD, PC CurrentSince Apr 1, 2010 Accepting new patients
Angela R. Gulbranson, OD, PC Optometrist Current Accepting new patients

Locations

106 W 69th St
Sioux Falls, SD 57108
Phone (605) 274-6717

6144 S Lyncrest Ave
Sioux Falls, SD 57108
Phone (605) 271-7100

6201 S Minnesota Ave
Sioux Falls, SD 57108
Phone (605) 274-6717

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1699723387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 S. MINNESOTA AVE",
            "city": "TEA",
            "state": "SD",
            "postal_code": "571082559",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 S. MINNESOTA AVE",
            "city": "TEA",
            "state": "SD",
            "postal_code": "571082559",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPKE",
        "first_name": "JENNIFER",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "0593",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0040692",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201722",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "SD0593",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201723",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY  HEALTH PLAN",
            "identifier": "30671",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201724",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "9212280",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tea, SD

Sources for this page

Verify at the official NPI Registry.