Dr. Bruce Lebert OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1591000 Issued in MN

Legal business name

DR. BRUCE LEBERT OD

Practice address

6575 Cahill Ave Ste 101
Inver Grove Heights, MN 55076-2065

Phone

(651) 451-1100

Fax

(651) 451-3939

NPI assigned

Mar 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Elden Lebert, O.D.

Title

Optometrist

Phone

(651) 351-5049

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Steven Charles Blashill, O.D.

  • Corneal and Contact Management Optometrist
  • Inver Grove Heights, MN
  • NPI 1942461470

  Corneal and Contact Management

  NPD (past)
• Christopher J Palmer, OD

  • Optometrist
  • Inver Grove Heights, MN
  • NPI 1366593162
  NPD (past)

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345593600000",
    "number": "1306017389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 JOHNSON DR",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824138",
            "telephone_number": "651-351-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6575 CAHILL AVE STE 101",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550762065",
            "telephone_number": "651-451-1100",
            "fax_number": "651-451-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRUCE LEBERT OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2012-08-22",
        "status": "A",
        "authorized_official_last_name": "LEBERT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ELDEN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "651-351-5049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1591000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "693823000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amy Donovan, PHD
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• Teresa Dee Dorey, RN
• Abdullahi Mohamed Dubed, PHARM.D.
• Dynamic Path Psychological Services, LLC
• East Metro Family Practice, P.a.
• Stephen Gerard Ebert, SLP
• Erica Eccles-Radtke, PSY.D.

• All providers in Inver Grove Heights, MN
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.