Chad M. Krietlow, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

MN2821 Issued in MN

Practice address

260 Northtown Dr NE
Blaine, MN 55434-1037

Phone

(763) 784-9049

Fax

(763) 717-6939

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Complete Eyecare P L C

  • Optometrist
  • Blaine, MN
  • NPI 1841577418
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1295849917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 NORTHTOWN DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341037",
            "telephone_number": "763-784-9049",
            "fax_number": "763-717-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 NORTHTOWN DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341037",
            "telephone_number": "763-784-9049",
            "fax_number": "763-717-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIETLOW",
        "first_name": "CHAD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN2821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "916244500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Kopp
• Anissa Jane Kozlowski, DDS
• Robb David Kozlowski, DDS
• Bariaala B Kpuinen, DNP, FNP-BC, CNP
• Abbie Kraemer, MA, LAMFT
• Jessica Krogman
• Traci Lynn Kruse, OTD, MA, OTR/L
• Landon Michael Kudrna, O.D.
• Bradley Kuehl, D.C.
• Sarah Marie Kunkel, PHARMD

• Optometrist in Blaine, MN
• Providers in Blaine, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.

Verify at the official NPI Registry.