Individual provider Active NPI

Ashley Walkoviak, O.D.

  • Optometrist
  • Rogers, MN
National Provider Identifier
1043699317
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3441 Issued in MN
Practice address
21615 S Diamond Lake Rd
Rogers, MN 55374-8893
Phone
(763) 428-9014
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MN
Optometrist 152W00000X 3441 MN Primary

Addresses

Primary practice location

21615 S Diamond Lake Rd
Rogers, MN 55374-8893

Mailing address

21615 S Diamond Lake Rd
Rogers, MN 55374-8893
Phone (763) 428-9014

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
I20150922003347 MN Practitioner - Optometry 0244547347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

1004 18TH Ave NW
Suite D
Austin, MN 55912-1993
Phone (507) 437-8228

205 16TH St NE
Suite D
Little Falls, MN 56345-4609
Phone (320) 632-9201

318 Jefferson St S
Suite 1
Wadena, MN 56482-1556
Phone (218) 631-3300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince Sep 26, 2022 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Sep 26, 2022 Accepting new patients
Midwest Vision Centers Inc PastSince Jun 1, 2016 Accepting new patients
Midwest Vision Centers Inc PastSince Jun 1, 2016 Accepting new patients

Locations

1004 18th Ave NW
Ste D
Austin, MN 55912
Phone (507) 437-8228

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

Organizations & group practices 5

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": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1043699317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21615 S DIAMOND LAKE RD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553748893",
            "telephone_number": "763-428-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21615 S DIAMOND LAKE RD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553748893",
            "telephone_number": "763-428-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKOVIAK",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, MN

Sources for this page

Verify at the official NPI Registry.