Active NPI
Josephine Rosemary Ausdemore, OD
- Optometrist
- Winona, MN
National Provider Identifier
1104564269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3784
- Practice address
- 1459 W Service Dr
Winona, MN 55987-2512 - Phone
- (507) 452-6175
- NPI assigned
- May 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3784 | MN | Primary |
Addresses
Primary practice location
1459 W Service Dr
Winona, MN 55987-2512
Mailing address
27566 Magnolia Rd
Underwood, IA 51576-3764
Phone (402) 681-5707
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220719002966 | MN | Practitioner - Optometry | 3678954856 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1459 W Service Dr
Winona, MN 55987-2512
Phone (507) 452-6175
2650 Broadway Ave S
Suite 400
Rochester, MN 55904-6259
Phone (507) 322-0044
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3784 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Bhend Family Eye Care, PLLC | Optometrist | Current | Accepting new patients |
Locations
1004 18th Ave NW
Ste D
Austin, MN 55912
Phone (507) 437-8228
2650 Broadway Ave S
Ste 400
Rochester, MN 55904
Phone (507) 322-0044
1459 W Service Dr
Winona, MN 55987
Phone (507) 452-6175
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653523200000",
"number": "1104564269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27566 MAGNOLIA RD",
"city": "UNDERWOOD",
"state": "IA",
"postal_code": "515763764",
"telephone_number": "402-681-5707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1459 W SERVICE DR",
"city": "WINONA",
"state": "MN",
"postal_code": "559872512",
"telephone_number": "507-452-6175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSDEMORE",
"first_name": "JOSEPHINE",
"middle_name": "ROSEMARY",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-26",
"last_updated": "2022-05-26",
"certification_date": "2022-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.