Individual provider Active NPI

Denise M Hanson, OD

  • Optometrist
  • Fergus Falls, MN
National Provider Identifier
1730264904
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
LD2736000 Issued in MN
Practice address
810 N Baird Ave
Fergus Falls, MN 56537-1617
Phone
(218) 736-5609
Fax
(218) 736-5600
NPI assigned
Oct 26, 2006
Last updated
Jan 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X LD2736000 MN Primary

Addresses

Primary practice location

810 N Baird Ave
Fergus Falls, MN 56537-1617

Mailing address

810 N Baird Ave
Fergus Falls, MN 56537-1617
Phone (218) 736-5609

Other identifiers 6

IdentifierTypeStateIssuer
282T0HAOtherMNBCBS
670938900MedicaidMN
1021893OtherMNPREFERRED ONE
60535MedicaidND
HAN892736OtherNDND VISION SERVICE
2201477OtherMNMEDICA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100914001397 MN Practitioner - Optometry 8224940580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fergus Falls Vision Care PAGroup PAC ID 1456263706, 5 clinicians

Practice addresses (Care Compare)

810 N Baird Ave
Fergus Falls, MN 56537-1617
Phone (218) 736-5609

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD2736000MNMDOptometrist
2736MNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Fergus Falls Vision Care PA Optometrist CurrentSince Oct 1, 2002 Accepting new patients

Locations

810 N Baird Ave
Fergus Falls, MN 56537
Phone (218) 736-5609

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1730264904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N BAIRD AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371617",
            "telephone_number": "218-736-5609",
            "fax_number": "218-736-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N BAIRD AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371617",
            "telephone_number": "218-736-5609",
            "fax_number": "218-736-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "DENISE",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "LD2736000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "282T0HA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670938900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1021893",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60535",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND VISION SERVICE",
            "identifier": "HAN892736",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2201477",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.