Optometry Clinic, PC
NPI 1225686827ActiveOrganization· Optometrist· Kenmare, ND
Optometrist in Kenmare, North Dakota, registered in NPPES in August 2019. The authorized official on file is Tesha Gustafson, OD, Owner/Optometrist. Enrolled in Medicare as dme supplier - physician - optometrist and part b supplier - clinic/group practice.
Overview
| NPI | 1225686827 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 28, 2019 |
| Last updated in NPPES | Sep 18, 2020 |
| Certified by provider | Sep 17, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (ND); Part B Supplier - Clinic/Group Practice (ND) |
|---|
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