Corey H Tabbert, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2883 Issued in MN

Practice address

222 SE First Street
Wadena, MN 56482

Phone

(218) 631-2020

Fax

(218) 631-1892

NPI assigned

Mar 9, 2006

Last updated

Apr 30, 2008By 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 9

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

Specialty

Optometry

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Corey H Tabbert OD PAGroup PAC ID 3476709932, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Corey H Tabbert OD PA

  • Optometrist
  • Grand Rapids, MN
  • NPI 1447525316
  Medicare reassignment Care Compare group NPD Authorized official
• Morrison Eye Care Optometrists, P.a.

  • Optometrist
  • Detroit Lakes, MN
  • NPI 1164517348
  Medicare reassignment NPD
• Morrison Eye Care Optometrists, P.a.

  • Optometrist
  • Mahnomen, MN
  • NPI 1386679033
  NPD
• Brainerd Eyecare Center, PA

  • Optician
  • Brainerd, MN
  • NPI 1871856229

  Optometrist

  NPD (past)
• Brainerd Eyecare Center, PA

  • Optometrist
  • Brainerd, MN
  • NPI 1942351002
  NPD (past)
• Richard a. Perrott OD PA

  • Optometrist
  • Grand Rapids, MN
  • NPI 1760607816
  NPD (past)
• Fercho Cataract & Eye Clinic, Inc.

  • Ophthalmology Physician
  • Fargo, ND
  • NPI 1447348602
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1902874480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 1ST ST SE",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821567",
            "telephone_number": "218-631-2020",
            "fax_number": "218-631-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SE FIRST STREET",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "56482",
            "telephone_number": "218-631-2020",
            "fax_number": "218-631-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABBERT",
        "first_name": "COREY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PLUS",
            "identifier": "365T9TA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "999995765",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP36359",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "MN2883",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410002031",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1032301",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH COUNTY HEALTH ALLIANCE",
            "identifier": "365T9TA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-02149",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "365T9TA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Joy Small, BS
• Rachael Lynn Spear, CRNA
• Shawn Stafki, MD
• Julie Kay Starkey-Labat, LICSW
• Melissa Lee Stave, MS, LADC, LPCC, NCC
• Christopher J Thanel, M.D.
• The Clinic LLC
• Karmella J Thompson, MS, LMFT, LADC
• Thrifty Drug Stores Inc (Thrifty White Pharmacy #778)
• Thrifty Drug Stores Inc (Thrifty White Pharmacy #795)

• Optometrist in Wadena, MN
• Providers in Wadena, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.