Active NPI
Jenna Nicole Goeppner, OD
- Optometrist
- Edina, MN
National Provider Identifier
1285565374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4055
- Practice address
- 5266 W 74TH St
Edina, MN 55439-2223 - Phone
- (952) 486-7858
- Fax
- (952) 674-4641
- NPI assigned
- May 27, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4055 | MN | Primary |
Addresses
Primary practice location
5266 W 74TH St
Edina, MN 55439-2223
Mailing address
5266 W 74TH St
Edina, MN 55439-2223
Phone (952) 486-7858
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260612001780 | MN | Practitioner - Optometry | 9335611169 |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7731 Flying Cloud Dr
Eden Prairie, MN 55344-3708
Phone (952) 486-7858
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4055 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afira Hasan, O.D., PLLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1285565374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5266 W 74TH ST",
"city": "EDINA",
"state": "MN",
"postal_code": "554392223",
"telephone_number": "952-486-7858",
"fax_number": "952-674-4641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5266 W 74TH ST",
"city": "EDINA",
"state": "MN",
"postal_code": "554392223",
"telephone_number": "952-486-7858",
"fax_number": "952-674-4641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEPPNER",
"first_name": "JENNA",
"middle_name": "NICOLE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-27",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "4055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.