Eyecare MPLS PLLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

56474 Issued in MN

Legal business name

EYECARE MPLS PLLC

Practice address

3033 Excelsior Blvd
Suite 205
Minneapolis, MN 55416-4688

Phone

(612) 470-9871

NPI assigned

Jan 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Stella Hennen, MD, MSPHNPI 1114108750

Title

Glaucoma Specialist/Owner

Phone

(612) 470-9871

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, and the practitioner matching its NPPES authorized official.

• Stella N.Y.a. Hennen, MD, MSPH

  • Ophthalmology Physician
  • Minneapolis, MN
  • NPI 1114108750
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1245629369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD",
            "address_2": "SUITE 205",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164688",
            "telephone_number": "612-470-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD",
            "address_2": "SUITE 205",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164688",
            "telephone_number": "612-470-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE MPLS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "HENNEN",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "GLAUCOMA SPECIALIST/OWNER",
        "authorized_official_telephone_number": "612-470-9871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MSPH"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "MN",
            "license": "56474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyeswear (Uptowm Eyeswear)
• Raye McPhillips Eyrich, PH.D.
• Adaolisa Ezechukwu
• Karen Marie Ezuck, OT

• Ophthalmologic Surgery Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Ophthalmologic Surgery Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.