John Mark Cavanagh, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2236 Issued in MN

Practice address

2655 Innsbruck Dr
Suite B
New Brighton, MN 55112-9303

Phone

(651) 636-2020

Fax

(651) 633-5036

NPI assigned

Oct 4, 2006

Last updated

Mar 18, 2009By 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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Academy Contact Lens Clinic

  • Optometrist
  • New Brighton, MN
  • NPI 1639202559
  Medicare reassignment NPD Authorized official
• Monticello Optical Center Inc.

  • Optometrist
  • Monticello, MN
  • NPI 1629591490
  NPD Authorized official
• Northwest Eye Clinic, LLC

  • Ophthalmology Physician
  • St Anthony, MN
  • NPI 1255417002
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1205921368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 INNSBRUCK DR",
            "address_2": "SUITE B",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551129303",
            "telephone_number": "651-636-2020",
            "fax_number": "651-633-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 INNSBRUCK DR",
            "address_2": "SUITE B",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551129303",
            "telephone_number": "651-636-2020",
            "fax_number": "651-633-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAGH",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corbin Casalenda, LICSW
• Allyson Case
• Nancy Jane Cashman, DDS
• Jason T Caspillo
• Alexandra Marian Castellanos, LICSW
• Byung Kwon Cha, D.C.
• Kris Chaffee, PSYD, LP
• Heidi Christenson
• Joshua Lee Christianson, LADC
• Edward Loon Chua, MD

• Optometrist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.