Maple Grove Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MAPLE GROVE EYE CARE, LLC

Practice address

9885 Maple Grove Parkway
Maple Grove, MN 55369

Phone

(952) 807-4173

NPI assigned

Aug 29, 2023

Organization subpart

No

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

Authorized official

Name

Quy T Tran, ODNPI 1619164290

Title

Ceo

Phone

(952) 807-4173

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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

• Quy T Tran, OD

  • Optometrist
  • Elk River, MN
  • NPI 1619164290
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1184409153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17399 78TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553114626",
            "telephone_number": "952-807-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9885 MAPLE GROVE PARKWAY",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "952-807-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE GROVE EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-26",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "QUY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-807-4173",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianne Marie Mansfield, PT
• Maple Grove Center for Restorative Surgery
• Maple Grove Center for Restorative Surgery LLC
• Maple Grove Counseling Center PA
• Maple Grove Dialysis LLC
• Maple Grove Family Dental Clinic, PA
• Maple Grove Hospital Corporation
• Maple Grove Hospital Corporation
• Maple Grove Periodontics and Implant Dentistry
• Maple Grove Smiles Dentistry, PC

• Optometrist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.