Individual provider Active NPI

Katherine Ann Montealegre, OD

  • Corneal and Contact Management Optometrist
  • St Paul, MN
National Provider Identifier
1295097277
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
3285 Issued in MN
Practice address
401 Phalen Blvd
Ms 41102E
St Paul, MN 55130-5302
Phone
(651) 254-7500
Fax
(651) 254-7557
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 3285 MN Primary

Addresses

Primary practice location

401 Phalen Blvd
Ms 41102E
St Paul, MN 55130-5302

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516
Phone (651) 254-7500

Other practice location 1

9801 DuPont Ave S
Suite 425
Bloomington, MN 55431-3100
Phone (952) 888-5800

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
I20120719000158 MN Practitioner - Optometry 6507022514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3285MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Mar 6, 2017 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Mar 6, 2017 Accepting new patients

Locations

1210 County Road E W
Arden Hills, MN 55112
Phone (651) 523-8400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

401 Phalen Blvd
#41102E
Saint Paul, MN 55130
Phone (651) 254-7500

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870

Interoperability endpoints

  • Direct secure messaging: kmontealegre178036@direct.healthpartners.com

Organizations & group practices 3

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1295097277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-7500",
            "fax_number": "651-254-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PHALEN BLVD",
            "address_2": "MS 41102E",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-7500",
            "fax_number": "651-254-7557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9801 DuPont Ave S",
            "address_2": "Suite 425",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554313100",
            "country_code": "US",
            "telephone_number": "952-888-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTEALEGRE",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "3285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

Verify at the official NPI Registry.