Individual provider Active NPI

Elizabeth May Mosley, O.D.

  • Optometrist
  • Elk River, MN
National Provider Identifier
1205212446
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3531 Issued in MN
Practice address
19576 Holt St NW
Elk River, MN 55330-1287
Phone
(763) 241-2083
Fax
(763) 241-3801
NPI assigned
Aug 10, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3531 MN Primary

Addresses

Primary practice location

19576 Holt St NW
Elk River, MN 55330-1287

Mailing address

3333 Hazelton Rd
Edina, MN 55435-4204
Phone (952) 926-6149

Other practice location 1

3333 Hazelton Rd
Edina, MN 55435-4204
Phone (952) 926-6149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171003004262 MN Practitioner - Optometry 0143500512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perspectives Optometric Vision Clinic, PCGroup PAC ID 8426135757, 3 clinicians

Practice addresses (Care Compare)

3102 W 50TH St
Minneapolis, MN 55410-2101
Phone (612) 920-3938

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Optical LLC CurrentSince Sep 1, 2017 Accepting new patients
Perspectives Optometric Vision Clinic, PC Optometrist CurrentSince Jun 8, 2023 Accepting new patients
Minnesota Optical LLC Optometrist Current Accepting new patients

Locations

19576 Holt St NW
Elk River, MN 55330
Phone (763) 241-2083

3333 Hazelton Rd
Minneapolis, MN 55435
Phone (952) 926-6149

3102 W 50th St
Minneapolis, MN 55410
Phone (612) 920-3938

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205212446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 HAZELTON RD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354204",
            "telephone_number": "952-926-6149",
            "fax_number": "952-926-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19576 HOLT ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301287",
            "telephone_number": "763-241-2083",
            "fax_number": "763-241-3801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Hazelton Rd",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554354204",
            "country_code": "US",
            "telephone_number": "952-926-6149",
            "fax_number": "952-926-2729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "ELIZABETH",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.