Individual provider Active NPI

Jeanette Larose Steffl

  • Optometrist
  • Woodbury, MN
National Provider Identifier
1144505298
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3389 Issued in MN
Practice address
8325 Seasons Pkwy
Woodbury, MN 55125-3477
Phone
(651) 702-5868
Fax
(651) 702-5870
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3343-35 WI
Optometrist 152W00000X 3389 MN Primary

Addresses

Primary practice location

8325 Seasons Pkwy
Woodbury, MN 55125-3477

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516

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
I20150723007254 MN Practitioner - Optometry 7618194739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3343-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 14, 2015 Accepting new patients
Group Health, Inc. CurrentSince Sep 14, 2015 Accepting new patients
Group Health, Inc. CurrentSince May 16, 2021 Accepting new patients

Locations

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

2500 Como Ave
Stop 31100A
Saint Paul, MN 55108
Phone (651) 641-6200

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

8325 Seasons Pkwy
Ste 103
Woodbury, MN 55125
Phone (651) 702-5848

8325 Seasons Pkwy
Woodbury, MN 55125
Phone (651) 702-5848

Organizations & group practices 3

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": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1144505298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 SEASONS PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253477",
            "telephone_number": "651-702-5868",
            "fax_number": "651-702-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFFL",
        "first_name": "JEANETTE",
        "middle_name": "LAROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3343-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.