Active NPI
Kelly Noel Freese, OD
- Optometrist
- Sartell, MN
National Provider Identifier
1003227059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT-0022511
- Practice address
- 2380 Troop Dr
Suite201
Sartell, MN 56377-4636 - Phone
- (320) 258-3915
- Fax
- (320) 258-3917
- NPI assigned
- May 13, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT-0022511 | AZ | Primary |
Addresses
Primary practice location
2380 Troop Dr
Suite201
Sartell, MN 56377-4636
Mailing address
220 N McKemy Ave
Chandler, AZ 85226-2654
Phone (480) 835-4472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210112001781 | AZ | Practitioner - Optometry | 2961628250 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2014
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Dnanda Eyecare PLLCFamily First Vision Care Arizona PLLC
Practice addresses (Care Compare)
1831 E Camelback Rd
Suite B2
Phoenix, AZ 85016-4162
Phone (480) 627-8689
937 N Dobson Rd
Suite 102
Mesa, AZ 85201-7589
Phone (480) 649-6100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT-0022511 | AZ | MD | Optometrist |
Practice roles (4 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DN&a Eyecare PLLC | Optometrist | Current | Accepting new patients |
| Dr. Nez and Associates Inc | Optometrist | Current | Accepting new patients |
| Emergency Medical & Surgical Specialists of Colorado LLC | Past | Accepting new patients | |
| West Point Optical Group | Optometrist | Past | Accepting new patients |
Locations
1649 S Stapley Dr
Ste 108
Mesa, AZ 85204
Phone (480) 345-7520
1831 E Camelback Rd
Ste B2
Phoenix, AZ 85016
Phone (480) 345-7520
Networks
- NM HMO C-SNP
Organizations & group practices 5
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.
-
- Optometrist
- Chandler, AZ
- NPI 1902492010
-
- Critical Access Hospital
- Denver, CO
- NPI 1144669102
-
- Optometrist
- Phoenix, AZ
- NPI 1679005821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1003227059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 N MCKEMY AVE",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852262654",
"telephone_number": "480-835-4472",
"fax_number": "480-893-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2380 TROOP DR",
"address_2": "SUITE201",
"city": "SARTELL",
"state": "MN",
"postal_code": "563774636",
"telephone_number": "320-258-3915",
"fax_number": "320-258-3917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREESE",
"first_name": "KELLY",
"middle_name": "NOEL",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-13",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "OPT-0022511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sartell, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.