Organization Active NPI

St. Paul Opticians, Inc.

  • Eyewear Supplier
  • Oak Park Heights, MN
National Provider Identifier
1154727055
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
ST. PAUL OPTICIANS, INC.
Practice address
5945 Norwich Ave N
Oak Park Heights, MN 55082-1290
Phone
(651) 351-2038
Fax
(651) 342-2530
NPI assigned
Nov 5, 2014
Last updated
Nov 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

5945 Norwich Ave N
Oak Park Heights, MN 55082-1290

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
O20150204000528 MN DME Supplier - OpticianDME Supplier - Physician - Ophthalmology 5597981308 Practice locations: Oak Park Heights, MN

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Locations

1093 Grand Ave
Saint Paul, MN 55105
Phone (651) 222-7343

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1154727055",
    "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": "5945 NORWICH AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550821290",
            "telephone_number": "651-351-2038",
            "fax_number": "651-342-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PAUL OPTICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "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 Oak Park Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.