Individual provider Active NPI

Joseph Anthony Schneiderhan, O.D.

  • Optometrist
  • Glenwood, MN
National Provider Identifier
1003859786
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2417 Issued in MN
Practice address
16 Minnesota Ave W Ste 102
Glenwood, MN 56334-1558
Phone
(320) 334-3264
Fax
(320) 334-3182
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 8

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital District 69 clinicians

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

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
I20040819000753 MN Practitioner - Optometry 3870566540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2417MNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Glacial Ridge Hospital District CurrentSince Jun 1, 2016 Accepting new patients
Glacial Ridge Hospital District CurrentSince Jun 1, 2016 Accepting new patients
Glacial Ridge Hospital District Past Accepting new patients
Lake Region Eye Center Optometrist Past Accepting new patients

Locations

16 Minnesota Ave W
Ste 102
Glenwood, MN 56334
Phone (320) 334-3264

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2417 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

16 Minnesota Ave W Ste 102
Glenwood, MN 56334-1558

Mailing address

16 Minnesota Ave W Ste 102
Glenwood, MN 56334-1558
Phone (320) 334-3264

Other practice location 1

501 Highway 10 SE
Saint Cloud, MN 56304-1250
Phone (320) 253-4695

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
597816500MedicaidMN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003859786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MINNESOTA AVE W STE 102",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341558",
            "telephone_number": "320-334-3264",
            "fax_number": "320-334-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MINNESOTA AVE W STE 102",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341558",
            "telephone_number": "320-334-3264",
            "fax_number": "320-334-3182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Highway 10 SE",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563041250",
            "country_code": "US",
            "telephone_number": "320-253-4695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNEIDERHAN",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "597816500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood, MN

Sources for this page

Verify at the official NPI Registry.