Organization Active NPI

Runestone Eye Care, Inc.

  • Optometrist
  • Alexandria, MN
National Provider Identifier
1184606949
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2383 Issued in MN
Legal business name
RUNESTONE EYE CARE, INC.
Doing business as
Runestone Eye Care
Practice address
3015 Highway 29 S
Suite 4155
Alexandria, MN 56308-3486
Phone
(320) 759-1130
NPI assigned
Nov 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Dr. Paul William Wysoski, O.D.
Title
President
Phone
(320) 759-1130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2383 MN Primary

Addresses

Primary practice location

3015 Highway 29 S
Suite 4155
Alexandria, MN 56308-3486

Mailing address

3015 Highway 29 S
Suite 4155
Alexandria, MN 56308-3486
Phone (320) 759-1130

Other identifiers 6

IdentifierTypeStateIssuer
1024868OtherMNPREFERRED ONE
971325500MedicaidMN
2200241OtherMNMEDICA
30701135OtherMNPRIMEWEST
66Q23RUOtherMNBCBS
66Q26RUOtherMNBCBS

Other names 1

  • Runestone Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

3015 Highway 29 S
Ste 4155
Alexandria, MN 56308
Phone (320) 759-1130

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1184606949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 29 S",
            "address_2": "SUITE 4155",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083486",
            "telephone_number": "320-759-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 29 S",
            "address_2": "SUITE 4155",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083486",
            "telephone_number": "320-759-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUNESTONE EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "WYSOSKI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-759-1130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1024868",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "971325500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2200241",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "30701135",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "66Q23RU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "66Q26RU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Runestone Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.