Individual provider Active NPI

Renee M Ritzer, OD

  • Optometrist
  • Maple Grove, MN
National Provider Identifier
1063561066
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2414 Issued in MN
Practice address
13195 Weaver Lake Road
Maple Grove, MN 55369
Phone
(763) 599-0153
Fax
(763) 420-6957
NPI assigned
Jan 9, 2007
Last updated
May 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2414 MN Primary
Optometrist 152W00000X 2614 WI

Addresses

Primary practice location

13195 Weaver Lake Road
Maple Grove, MN 55369

Mailing address

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410
Phone (763) 420-5112

Other identifiers 1

IdentifierTypeStateIssuer
U47843OtherMNWOODBURY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041112000521 MN Practitioner - Optometry 6800850686 Reassigns benefits to 1 organization
I20240510001473 WI Practitioner - Optometry 6800850686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sees the Day LTDGroup PAC ID 7517921372, 8 clinicians

Practice addresses (Care Compare)

113 Carmichael Rd
Hudson, WI 54016-7716
Phone (715) 377-7970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2614WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brokea Inc. Optometrist CurrentSince Jun 23, 2015 Accepting new patients
Sees the Day LTD CurrentSince Apr 1, 2024 Accepting new patients
Sees the Day LTD Optometrist CurrentSince Apr 1, 2024 Accepting new patients
Sees the Day LTD Optometrist Past Accepting new patients

Locations

1757 N Frontage Rd
Hastings, MN 55033
Phone (651) 480-8515

13195 Weaver Lake Rd
Maple Grove, MN 55369
Phone (763) 420-5112

7150 Valley Creek Plz
Ste 216
Woodbury, MN 55125
Phone (651) 738-4886

113 Carmichael Rd
Hudson, WI 54016
Phone (715) 377-7970

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1063561066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "763-420-5112",
            "fax_number": "763-420-6957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE ROAD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-599-0153",
            "fax_number": "763-420-6957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITZER",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2414",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2614",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WOODBURY",
            "identifier": "U47843",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.