Minnesota Eye Institute Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MINNESOTA EYE INSTITUTE SURGERY CENTER, LLC

Practice address

3401 S Broadway
Alexandria, MN 56308-3477

Phone

(320) 759-2020

Fax

(320) 759-2424

NPI assigned

Sep 26, 2005

Last updated

Sep 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kent Arthur Carlson, MDNPI 1518953306

Title

Owner

Phone

(320) 759-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Listed as

Minnesota Eye Institute Surgery Center LLCCCN 24C0001043

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kent Arthur Carlson, MD

  • Ophthalmology Physician
  • Alexandria, MN
  • NPI 1518953306
  Authorized official Same address or phone

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1003802950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 S BROADWAY",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083477",
            "telephone_number": "320-759-2020",
            "fax_number": "320-759-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 S BROADWAY",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083477",
            "telephone_number": "320-759-2020",
            "fax_number": "320-759-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA EYE INSTITUTE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-759-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382112900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Marie Miller
• Julie J Miller, LRD,CDE
• Kaylee Miller, DPM
• Riley Miller
• Scott Minnerath, OD
• Minnesota Eye Institute, Inc.
• Minnesota Teen Challenge, Inc
• Minnesota Teen Challenge, Inc (Minnesota Adult & Teen Challenge)
• Michelle C Mirau, MD
• Jacquelyn J Miron, R.PH

• Ambulatory Surgical Clinic/Center in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.