Individual provider Active NPI

Melissa L Johnsen, OD

  • Optometrist
  • Grand Forks, ND
National Provider Identifier
1992890586
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
618 Issued in ND
Practice address
2501 32ND Ave S Ste B
Grand Forks, ND 58201-6573
Phone
(701) 795-1441
Fax
(701) 335-2443
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 618 ND Primary

Addresses

Primary practice location

2501 32ND Ave S Ste B
Grand Forks, ND 58201-6573

Mailing address

2501 32ND Ave S Ste B
Grand Forks, ND 58201-6573
Phone (701) 795-1441

Other identifiers 2

IdentifierTypeStateIssuer
2914OtherMNSTATE LICENSE
618OtherNDSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20040503001339 ND Practitioner - Optometry 4981692563 Practice locations: Grand Forks, ND

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2800 S Columbia Rd
Grand Forks, ND 58201-6076
Phone (701) 795-1441

2800 S Columbia Rd
Suite 81
Grand Forks, ND 58201-6013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1992890586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 32ND AVE S STE B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016573",
            "telephone_number": "701-795-1441",
            "fax_number": "701-335-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 32ND AVE S STE B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016573",
            "telephone_number": "701-795-1441",
            "fax_number": "701-335-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "MELISSA",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2914",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "618",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.