Ashley M Gentrup, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

712 Issued in SD

Practice address

106 W 69TH St
Sioux Falls, SD 57108-6417

Phone

(605) 274-6717

Fax

(605) 275-4804

NPI assigned

Aug 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Southern College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Angela R. Gulbranson, OD PCGroup PAC ID 9830159979, 4 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.

• Angela R. Gulbranson, OD, PC

  • Optometrist
  • Sioux Falls, SD
  • NPI 1235309162
  Medicare reassignment Care Compare group NPD
• Angela R. Gulbranson OD, PC

  • Vision Therapy Optometrist
  • Sioux Falls, SD
  • NPI 1154754489
  NPD

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1962835017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 S. MINNESOTE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082559",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086417",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRUP",
        "first_name": "ASHLEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1941DT",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "SD",
            "license": "712",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "KY",
            "license": "1941DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9204450",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9204452",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.