Individual provider Active NPI

Melissa Marie Kuntz, OD

  • Optometrist
  • Duluth, MN
National Provider Identifier
1033130554
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13052 Issued in CA
Practice address
2510 Maple Grove Rd
Duluth, MN 55811-1807
Phone
(218) 722-2712
Fax
(218) 722-2712
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13052 CA Primary
Optometrist 152W00000X 3092-035 WI
Optometrist 152W00000X 3072 MN

Addresses

Primary practice location

2510 Maple Grove Rd
Duluth, MN 55811-1807

Mailing address

2510 Maple Grove Rd
Duluth, MN 55811-1807
Phone (218) 722-2712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3072MNMDMental Health Counselor
3092-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Pro II Inc Optometrist PastSince Aug 1, 2012 Accepting new patients
Appy Professional Optometric Corporation Optometrist PastSince Jul 22, 2018 Accepting new patients
Lincoln Physical Therapy and Sports Rehab LLC Past Accepting new patients

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1033130554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 MAPLE GROVE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558111807",
            "telephone_number": "218-722-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 MAPLE GROVE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558111807",
            "telephone_number": "218-722-2712",
            "fax_number": "218-722-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZ",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13052",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3092-035",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.