Individual provider Active NPI

Steven L Sorensen, OD

  • Optometrist
  • Libby, MT
National Provider Identifier
1851463947
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
495 Issued in MT
Practice address
422 Louisiana Ave
Libby, MT 59923
Phone
(406) 293-4136
Fax
(406) 293-2033
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 495 MT Primary

Addresses

Primary practice location

422 Louisiana Ave
Libby, MT 59923

Mailing address

422 Louisiana Ave
Libby, MT 59923
Phone (406) 293-4136

Other identifiers 2

IdentifierTypeStateIssuer
0483522MedicaidMT
0481468MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20050502000977 MT Practitioner - Optometry 0042259707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

422 Louisiana Ave
Libby, MT 59923-2132
Phone (406) 293-4136

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
495MTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Vision Centers PC Optometrist CurrentSince Aug 16, 1993 Accepting new patients
Kootenai Vision Centers PC Optometrist Past Accepting new patients

Locations

422 Louisiana Ave
Libby, MT 59923
Phone (406) 293-2134

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cabinet Peaks Medical CenterLibby, MT, CCN 271320 Hospital Corporate Director Jul 5, 1994
Cabinet Peaks Medical CenterLibby, MT, CCN 27Z320 Hospital Corporate Director Jul 5, 1994
Cabinet Peaks Family MedicineLibby, MT, CCN 273435 Rural health clinic Corporate Director Mar 14, 2016

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1851463947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 LOUISIANA AVE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "59923",
            "telephone_number": "406-293-4136",
            "fax_number": "406-293-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 LOUISIANA AVE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "59923",
            "telephone_number": "406-293-4136",
            "fax_number": "406-293-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "STEVEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0483522",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481468",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libby, MT

Sources for this page

Verify at the official NPI Registry.