Individual provider Active NPI

Paul Chadima Hammond, O.D.

  • Optometrist
  • Coon Rapids, MN
National Provider Identifier
1285918268
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3463 Issued in MN
Practice address
3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2630
Phone
(763) 421-7420
NPI assigned
Oct 7, 2011
Last updated
Dec 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3463 MN Primary

Addresses

Primary practice location

3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2630

Mailing address

3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2630
Phone (763) 421-7420

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
I20160608000634 MN Practitioner - Optometry 8921308966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2630
Phone (763) 421-7420

Merit-based Incentive Payment System (MIPS)

Final score
85.52 of 100Reported as group
Quality
80.37
Promoting interoperability
96
Improvement activities
40
Cost
74.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edina Eye Physicians and Surgeons PA CurrentSince Jan 1, 2019 Accepting new patients
Edina Eye Physicians and Surgeons PA Optometrist Current Accepting new patients
Edina Eye Physicians and Surgeons PA CurrentSince Jan 1, 2019 Accepting new patients
Edina Eye Physicians and Surgeons PA Past Accepting new patients

Locations

11855 Ulysses St NE
Ste 140
Blaine, MN 55434
Phone (763) 421-7420

3777 Coon Rapids Blvd NW
Ste 100
Minneapolis, MN 55433
Phone (763) 421-7420

7450 France Ave S
Ste 100
Minneapolis, MN 55435
Phone (952) 832-8100

4520 Centerville Rd
White Bear Lk, MN 55127
Phone (651) 426-1141

Organizations & group practices 4

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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1285918268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 COON RAPIDS BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332630",
            "telephone_number": "763-421-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 COON RAPIDS BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332630",
            "telephone_number": "763-421-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "PAUL",
        "middle_name": "CHADIMA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-07",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.