Organization Active NPI

Ovitsky Vision Care of Minnesota PC

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1174010656
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OVITSKY VISION CARE OF MINNESOTA PC
Practice address
445 Minnesota St Ste 1500
Saint Paul, MN 55101-2269
Phone
(773) 588-3090
Fax
(773) 588-3210
NPI assigned
Apr 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Authorized official

Name
Michael Ovitsky
Title
Vice President
Phone
(773) 588-3090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

445 Minnesota St Ste 1500
Saint Paul, MN 55101-2269

Mailing address

445 Minnesota St Ste 1500
Saint Paul, MN 55101-2269
Phone (773) 588-3090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180730000367 MN Part B Supplier - Clinic/Group Practice 7810244407 Receives reassigned benefits from 5 practitioners
Practice locations: Minneapolis, MN; New Prague, MN; New Richland, MN; Osseo, MN; Plainview, MN; Roseville, MN; Rush City, MN; Saint Paul, MN…

National Provider Directory

National Provider Directory

Locations

511 W Blue Earth St
Lake Crystal, MN 56055
Phone (507) 726-6537

5700 E River Rd
Minneapolis, MN 55432
Phone (763) 571-3150

501 2nd St SE
Osseo, MN 55369
Phone (763) 425-3939

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1174010656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 MINNESOTA ST STE 1500",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012269",
            "telephone_number": "773-588-3090",
            "fax_number": "773-588-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 MINNESOTA ST STE 1500",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012269",
            "telephone_number": "773-588-3090",
            "fax_number": "773-588-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVITSKY VISION CARE OF MINNESOTA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "OVITSKY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "773-588-3090"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.