Patjac Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

PATJAC INC.

Doing business as

Pearle Vision

Practice address

1301 33Rd St S
Ste 104
Saint Cloud, MN 56301-9668

Phone

(320) 252-0509

Fax

(320) 252-5386

NPI assigned

Jul 19, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Pat Kane

Title

Owner/Optician

Phone

(320) 252-0509

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Pearle Vision Doing business as

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1275552382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 33RD ST S STE 104",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019668",
            "telephone_number": "320-252-0509",
            "fax_number": "320-252-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 33RD ST S",
            "address_2": "STE 104",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019668",
            "telephone_number": "320-252-0509",
            "fax_number": "320-252-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATJAC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "320-252-0509",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "563G3PE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "J738",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "562G3PE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "65377",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "21-00759",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "832255400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angie Lynn Paschke, CNP
• Kavisha Patel
• Kishan Patel
• Yogesh Arvind Patel, M.D.
• David Patenaude
• Patjac, Inc. (Pearle Vision)
• Patron Adult Day Services
• Patron Adult Foster Care
• Patron Companies
• Patron Home Health Companies

• Optician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Optician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.