NPIMap

Organization Active NPI

Dakota Eye Institute PC

  • Ophthalmology Physician
  • Bismarck, ND
National Provider Identifier
1962449835
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DAKOTA EYE INSTITUTE PC
Practice address
200 S 5TH St
Bismarck, ND 58504-5675
Phone
(701) 222-3937
Fax
(701) 222-8805
NPI assigned
Jun 1, 2006
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Mrs. Aleesa A Brorby
Title
Administrator
Phone
(701) 222-3937

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Cornea and External Diseases Specialist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0120X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

200 S 5TH St
Bismarck, ND 58504-5675

Mailing address

200 S 5TH St
Bismarck, ND 58504-5675
Phone (701) 222-3937

Other practice location 1

114 N Broadway St Ste 1
Linton, ND 58552-7017
Phone (701) 254-4450

Other practice location 2

3119 N 14th St
Bismarck, ND 58503-0664
Phone (701) 222-3937

Other identifiers 1

IdentifierTypeStateIssuer
1453152MedicaidND

Other names 1

  • The Eye Specialists PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330001577 ND Part B Supplier - Clinic/Group Practice 2062404205 Receives reassigned benefits from 15 practitioners
Practice locations: Bismarck, ND; Linton, ND; Dickinson, ND

National Provider Directory

National Provider Directory

Locations

3119 N 14th St
Bismarck, ND 58503
Phone (701) 222-3937

114 N Broadway St
Ste 1
Linton, ND 58552
Phone (701) 254-4450

201 7th St SW
#2
Rugby, ND 58368
Phone (701) 776-5242

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1962449835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 5TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045675",
            "telephone_number": "701-222-3937",
            "fax_number": "701-222-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 5TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045675",
            "telephone_number": "701-222-3937",
            "fax_number": "701-222-8805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 N Broadway St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Linton",
            "state": "ND",
            "postal_code": "585527017",
            "country_code": "US",
            "telephone_number": "701-254-4450",
            "fax_number": "701-254-4550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3119 N 14th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585030664",
            "country_code": "US",
            "telephone_number": "701-222-3937",
            "fax_number": "701-222-8805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAKOTA EYE INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "BRORBY",
        "authorized_official_first_name": "ALEESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-222-3937",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1453152",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Specialists PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Eye Specialists PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.