Individual provider Active NPI

Michael David Sufka, OD

  • Optometrist
  • Saint Cloud, MN
National Provider Identifier
1083601165
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2751 Issued in MN
Practice address
1545 Northway Dr
Ste 120
Saint Cloud, MN 56303-1940
Phone
(320) 253-2441
Fax
(320) 253-2446
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2751 MN Primary

Addresses

Primary practice location

1545 Northway Dr
Ste 120
Saint Cloud, MN 56303-1940

Mailing address

1545 Northway Dr
Ste 120
Saint Cloud, MN 56303-1940
Phone (320) 253-2441

Other names 1

  • Michael D Sufka Other name

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
I20050823000790 MN Practitioner - Optometry 1153352828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagan Eye Clinic LLCGroup PAC ID 0345220745, 48 clinicians

Practice addresses (Care Compare)

1545 Northway Dr
Suite 120
Saint Cloud, MN 56303-1941
Phone (320) 253-2441

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2751MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Eye Clinic LLC Optometrist CurrentSince May 1, 2020 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince May 1, 2020 Accepting new patients

Locations

1545 Northway Dr
Ste 120
Saint Cloud, MN 56303
Phone (320) 253-2441

3930 Cedar Grove Pkwy
Saint Paul, MN 55122
Phone (612) 454-5661

Organizations & group practices 2

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083601165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 NORTHWAY DR",
            "address_2": "STE 120",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031940",
            "telephone_number": "320-253-2441",
            "fax_number": "320-253-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 NORTHWAY DR",
            "address_2": "STE 120",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031940",
            "telephone_number": "320-253-2441",
            "fax_number": "320-253-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFKA",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "SUFKA",
            "middle_name": "D",
            "credential": "OK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.