J Scott Endres, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2303 Issued in MN

Practice address

5730 Bottineau Blvd.
Crystal, MN 55429-3181

Phone

(763) 537-3213

Fax

(763) 537-6732

NPI assigned

Jun 8, 2005

Last updated

May 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Crystal Vision Clinic PA

  • Optometrist
  • Crystal, MN
  • NPI 1720480007
  NPD
• Maple Grove Vision Clinic, P.a.

  • Optometrist
  • Maple Grove, MN
  • NPI 1366472342
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1205830254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 BOTTINEAU BLVD.",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293181",
            "telephone_number": "763-537-3213",
            "fax_number": "763-537-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 BOTTINEAU BLVD.",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293181",
            "telephone_number": "763-537-3213",
            "fax_number": "763-537-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDRES",
        "first_name": "J",
        "middle_name": "SCOTT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Home Healthcare
• Elite School Transportation
• Eloes Heritage LLC
• Empowered Living: Mental Health Solutions (Empowered Living MH Solutions)
• Chase Endres
• Evergreen Hope Center LLC
• Face 2 Face Home Health Care LLC
• Face 2 Face Transportation Network LLC
• Fairview Health Services (Fairview Recovery Services)
• Fantasia Together Hair Designers Inc

• Optometrist in Crystal, MN
• Providers in Crystal, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.