Theresia F Dixon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2530 Issued in MN

Practice address

344 E Broadway
Mall of America
Bloomington, MN 55425-5514

Phone

(952) 858-8414

Fax

(952) 858-8416

NPI assigned

Jul 4, 2006

Sex

Female

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 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

Pacific University - College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS. North and Watson, Optometrists P. a.Group PAC ID 7315913670, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• DRS. North & Watson, Optometrists P. a.

  • Optometrist
  • Roseville, MN
  • NPI 1275560542
  Medicare reassignment Care Compare group NPD
• DRS. North & Watson, Optometrists P. a.

  • Optometrist
  • Bloomington, MN
  • NPI 1538199716
  NPD
• DRS. North & Watson, Optometrists P. a.

  • Optometrist
  • Burnsville, MN
  • NPI 1740210913
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1932139003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E BROADWAY",
            "address_2": "MALL OF AMERICA",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554255514",
            "telephone_number": "952-858-8414",
            "fax_number": "952-858-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E BROADWAY",
            "address_2": "MALL OF AMERICA",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554255514",
            "telephone_number": "952-858-8414",
            "fax_number": "952-858-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "THERESIA",
        "middle_name": "F",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301019800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Distad, OTD, OTR/L
• Lauren Elizabeth Disterhaft, OD
• Jaleel Marcus Ditele
• Diversity Health Service LLC
• Andrea Marie Dixey, PT
• Tiffani Doan-Suwak, DO
• Linda J. Dobberstein, DC
• Olivia Gale Dobbs, LICSW
• Ann Kathryn Houlihan Doda, PT, DPT
• Gina Marie Doeden, OD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.