Individual provider Active NPI

Terrence L Tancabel, O.D.

  • Optometrist
  • Litchfield, MN
National Provider Identifier
1861468670
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1765 Issued in MN
Practice address
135 N Sibley Ave
Litchfield, MN 55355-2138
Phone
(320) 593-3100
NPI assigned
Feb 23, 2006
Last updated
Jan 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1765 MN Primary

Addresses

Primary practice location

135 N Sibley Ave
Litchfield, MN 55355-2138

Mailing address

135 N Sibley Ave
Litchfield, MN 55355-2138
Phone (320) 593-3100

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
I20061212000286 MN Practitioner - Optometry 9133128572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Annandale Eye Clinic IncGroup PAC ID 6800897661, 5 clinicians

Practice addresses (Care Compare)

135 N Sibley Ave
Litchfield, MN 55355-2138
Phone (320) 593-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Annandale Eye Clinic Inc Optometrist CurrentSince Jan 1, 2007 Accepting new patients
Annandale Eye Clinic Inc Optometrist CurrentSince Jan 1, 2007 Accepting new patients

Locations

135 N Sibley Ave
Litchfield, MN 55355
Phone (320) 593-3100

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, 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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1861468670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553552138",
            "telephone_number": "320-593-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553552138",
            "telephone_number": "320-593-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANCABEL",
        "first_name": "TERRENCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, MN

Sources for this page

Verify at the official NPI Registry.