NPIMap

Individual provider Active NPI

Kevin Joseph Mueller, O.D.

  • Optometrist
  • Duluth, MN
National Provider Identifier
1164472148
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3042 Issued in MN
Practice address
324 W Superior St Ste 220
Duluth, MN 55802-1707
Phone
(218) 249-3570
Fax
(218) 722-8582
NPI assigned
May 11, 2006
Last updated
Dec 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2488 CO
Optometrist 152W00000X 3042 MN Primary

Addresses

Primary practice location

324 W Superior St Ste 220
Duluth, MN 55802-1707

Mailing address

324 W Superior St Ste 220
Duluth, MN 55802-1707
Phone (218) 249-3570

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100730000889 MN Practitioner - Optometry 1759314669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

4190 Loberg Ave
Duluth, MN 55811-2652
Phone (218) 249-4600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2488COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Apr 2, 2013 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Apr 2, 2013 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Austin & Treacy, P.a. Past Accepting new patients
Cerb Enterprises, Inc Past Accepting new patients
Springs Eyecare Optometrist PastSince May 15, 2006 Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients
Eye Associates of Colorado Springs, PC Optometrist Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

324 W Superior St
Ste 220
Duluth, MN 55802
Phone (218) 249-3500

324 W Superior St
Ste 800
Duluth, MN 55802
Phone (218) 249-3570

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

Interoperability endpoints

  • Direct secure messaging: kmueller350041@direct.aspirus.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1164472148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 220",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021707",
            "telephone_number": "218-249-3570",
            "fax_number": "218-722-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 220",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021707",
            "telephone_number": "218-249-3570",
            "fax_number": "218-722-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2488",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "324 W Superior St Ste 220",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558021707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.