Individual provider Active NPI

Carie Lynn Stotesbery, OD

  • Optometrist
  • Alexandria, MN
National Provider Identifier
1285715904
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2707 Issued in MN
Practice address
109 15TH Ave E
Alexandria, MN 56308-2509
Phone
(320) 762-5112
Fax
(320) 763-3297
NPI assigned
Oct 18, 2006
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2707 MN Primary

Addresses

Primary practice location

109 15TH Ave E
Alexandria, MN 56308-2509

Mailing address

109 15TH Ave E
Alexandria, MN 56308-2509
Phone (320) 762-5112

Other identifiers 1

IdentifierTypeStateIssuer
914218500MedicaidMN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101023000280 MN Practitioner - Optometry 6800089780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagan Eye Clinic LLCGroup PAC ID 0345220745, 48 clinicians

Practice addresses (Care Compare)

109 15TH Ave E
Alexandria, MN 56308-2509
Phone (320) 762-5112

1610 Broadway St
Alexandria, MN 56308-2708
Phone (320) 763-4321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Eye Clinic LLC Optometrist CurrentSince Nov 20, 2021 Accepting new patients
Gess Eye Clinic P.a. Optometrist CurrentSince Dec 21, 2025 Accepting new patients
Hometown Eye Care PA Optometrist CurrentSince Dec 21, 2025 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince Nov 20, 2021 Accepting new patients
Lake Region Eye Center Optometrist Past Accepting new patients
Dr. Jeffrey Pearson & Associates, P.a. Optometrist Past Accepting new patients

Locations

109 15th Ave E
Alexandria, MN 56308
Phone (320) 762-5112

1610 Broadway St
Alexandria, MN 56308
Phone (320) 763-4321

3930 Cedar Grove Pkwy
Saint Paul, MN 55122
Phone (612) 454-5661

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1285715904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 15TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082509",
            "telephone_number": "320-762-5112",
            "fax_number": "320-763-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 15TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082509",
            "telephone_number": "320-762-5112",
            "fax_number": "320-763-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTESBERY",
        "first_name": "CARIE",
        "middle_name": "LYNN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914218500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.