NPIMap

Organization Active NPI

St. Paul Opticians, Inc.

  • Eyewear Supplier
  • Woodbury, MN
National Provider Identifier
1124456413
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
ST. PAUL OPTICIANS, INC.
Practice address
2080 Woodwinds Dr
Suite 230
Woodbury, MN 55125-2523
Phone
(651) 578-6952
Fax
(651) 578-3074
NPI assigned
Oct 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Authorized official

Name
Dr. Thomas J. Rice, M.D.
Title
Ceo/President
Phone
(651) 738-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2080 Woodwinds Dr
Suite 230
Woodbury, MN 55125-2523

Mailing address

2080 Woodwinds Dr
Suite 110
Woodbury, MN 55125-2523
Phone (651) 738-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140813002933 MN DME Supplier - Optician 5597981308 Practice locations: Woodbury, MN

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
St. Paul Opticians, Inc.2080 Woodwinds Drive, Woodbury, MN 55125-2523(651) 578-6952 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jun 6, 2014

National Provider Directory

National Provider Directory
Tax ID family
St Paul Opticians Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2080 Woodwinds Dr
Ste 230
Woodbury, MN 55125
Phone (651) 578-6949

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1124456413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR",
            "address_2": "SUITE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252523",
            "telephone_number": "651-738-6800",
            "fax_number": "651-738-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR",
            "address_2": "SUITE 230",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252523",
            "telephone_number": "651-578-6952",
            "fax_number": "651-578-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PAUL OPTICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "651-738-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.