Real Eyes LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

REAL EYES LLC

Practice address

8332 Highway 7
Knollwood Mall
St Louis Park, MN 55426-3991

Phone

(952) 933-3722

Fax

(952) 933-6578

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Burrage

Title

Ceo

Phone

(952) 933-3722

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• PEARLE VISION Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Jackson, OD

  • Optometrist
  • Woodbury, MN
  • NPI 1083266126

  MN

  Medicare reassignment Care Compare group NPD
• Kristin S. McMurry, O.D.

  • Optometrist
  • Saint Louis, MO
  • NPI 1003885278

  MN

  Medicare reassignment Care Compare group NPD
• Beverly Jean Ludwig, O.D.

  • Optometrist
  • St Louis Park, MN
  • NPI 1215051214

  MN

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1295887883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8332 HIGHWAY 7",
            "address_2": "KNOLLWOOD MALL",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263991",
            "telephone_number": "952-933-3722",
            "fax_number": "952-933-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8332 HIGHWAY 7",
            "address_2": "KNOLLWOOD MALL",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263991",
            "telephone_number": "952-933-3722",
            "fax_number": "952-933-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL EYES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "BURRAGE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-933-3722",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC REGION B",
            "identifier": "0626900006",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "669479900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA-UHC",
            "identifier": "21-28989",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DR",
            "identifier": "21B67PE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS STORE",
            "identifier": "20B03PE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B WPS",
            "identifier": "C05046",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark A. Rawson, M.D.
• Katie Jo Ray, OTR/L
• RBF LLC
• Christa Joyce Reader, LICSW
• Diane M Reader, RD
• Realief Medical P.a.
• Realief Medical, P.a.
• Realief Neuropathy Center of Minnesota PA
• Wesley Rebarcak, D.C.
• Norman Hans Rechsteiner, M.D.

• All providers in St Louis Park, MN
• Optician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.