Timothy Todd Masters, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

01849 Issued in IA

Practice address

100 East Milwaukee Ave
Storm Lake, IA 50588-1873

Phone

(712) 732-7624

Fax

(712) 732-7627

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871644864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 CLOVER LANE",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505882702",
            "telephone_number": "712-732-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAST MILWAUKEE AVE",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881873",
            "telephone_number": "712-732-7624",
            "fax_number": "712-732-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "TIMOTHY",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2245720",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison County Medical Equipment Inc (Jackson Medical Supply)
• Diane Sue Mangold, LISW
• Marathon Health, LLC
• Rick Alan Martin, DDS
• Sabrina Marie Martinez, MD
• Linda Lou McClintock, ARNP
• Kimberlynn M McCoy, SLP
• Edward McKenna
• Margaret McKeon
• Mercy Medical Services (MercyOne Storm Lake Family Medicine)

• Optometrist in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.