Individual provider Active NPI

Carlee Jo Nestrud, OD

  • Optometrist
  • Lakeville, MN
National Provider Identifier
1003507997
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3863 Issued in MN
Practice address
16105 Cedar Ave
Lakeville, MN 55044-7213
Phone
(952) 985-6467
Fax
(952) 985-6468
NPI assigned
May 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3863 MN Primary

Addresses

Primary practice location

16105 Cedar Ave
Lakeville, MN 55044-7213

Mailing address

16105 Cedar Ave
Lakeville, MN 55044-7213
Phone (952) 985-6467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20230717003049 MN Practitioner - Optometry 0345600730 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsmith Eye Care PC Optometrist CurrentSince Jun 1, 2023 Accepting new patients
Focused Eye Care, PA Optometrist CurrentSince Mar 20, 2025 Accepting new patients
West Point Optical Group Optometrist CurrentSince Dec 5, 2023 Accepting new patients

Locations

16105 Cedar Ave
Lakeville, MN 55044
Phone (952) 985-6467

3333 Hazelton Rd
Minneapolis, MN 55435
Phone (952) 926-6149

1101 1st St NE
New Prague, MN 56071
Phone (952) 226-1400

Interoperability endpoints

  • Direct secure messaging: carlee.nestrud@direct.revolutionehr.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1003507997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16105 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447213",
            "telephone_number": "952-985-6467",
            "fax_number": "952-985-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447213",
            "telephone_number": "952-985-6467",
            "fax_number": "952-985-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTRUD",
        "first_name": "CARLEE",
        "middle_name": "JO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.