Individual provider Active NPI

Gregg A Bleeker, O.D.

  • Optometrist
  • Mitchell, SD
National Provider Identifier
1942271382
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
141 Issued in SD
Practice address
305 N Sanborn Blvd
Mitchell, SD 57301-2449
Phone
(605) 996-2537
Fax
(605) 996-0500
NPI assigned
Feb 1, 2006
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 141 SD Primary

Addresses

Primary practice location

305 N Sanborn Blvd
Mitchell, SD 57301-2449

Mailing address

305 N Sanborn Blvd
Mitchell, SD 57301-2449
Phone (605) 996-2537

Other identifiers 6

IdentifierTypeStateIssuer
27992OtherSDSANFORD HEALTH PLAN
0076519OtherSDWELLMARK BCBS
9201870MedicaidSD
141OtherSDDAKOTACARE
229999OtherSDMIDLANDS CHOICE
9201872MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20100519000770 SD Practitioner - Optometry 5294864880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mabee Eye Clinic PC Optometrist CurrentSince Jan 1, 1973 Accepting new patients

Locations

305 N Sanborn Blvd
Mitchell, SD 57301
Phone (605) 425-2855

740 S Hill St
Salem, SD 57058
Phone (605) 425-2855

Organizations & group practices 1

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1942271382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N SANBORN BLVD",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012449",
            "telephone_number": "605-996-2537",
            "fax_number": "605-996-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N SANBORN BLVD",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012449",
            "telephone_number": "605-996-2537",
            "fax_number": "605-996-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEEKER",
        "first_name": "GREGG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANFORD HEALTH PLAN",
            "identifier": "27992",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "0076519",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201870",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "141",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "229999",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201872",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.