Eye 35 Optometrists, LTD.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2182 Issued in MN

Legal business name

EYE 35 OPTOMETRISTS, LTD.

Practice address

18488 Kenyon Ave
Lakeville, MN 55044-6911

Phone

(952) 435-3505

NPI assigned

Jan 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Scott Thomas Fontana, O.D.

Title

Ceo

Phone

(952) 435-3505

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577404800000",
    "number": "1033394077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18488 KENYON AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446911",
            "telephone_number": "952-435-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18488 KENYON AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446911",
            "telephone_number": "952-435-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE 35 OPTOMETRISTS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A",
        "authorized_official_last_name": "FONTANA",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-435-3505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379652300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.