NPIMap

Organization Active NPI

Complete Vision Care, Inc.

  • Optometrist
  • Chaska, MN
National Provider Identifier
1306223151
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2805 Issued in MN
Legal business name
COMPLETE VISION CARE, INC.
Practice address
106 Pioneer TRL
Chaska, MN 55318-1167
Phone
(952) 368-2325
NPI assigned
Apr 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Dr. Sarah Krietlow, ODNPI 1831281989
Title
President
Phone
(952) 368-2325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2805 MN Primary

Addresses

Primary practice location

106 Pioneer TRL
Chaska, MN 55318-1167

Mailing address

106 Pioneer TRL
Chaska, MN 55318-1167
Phone (952) 368-2325

Other names 1

  • PEARLE VISION Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150825004156 MN Part B Supplier - Clinic/Group Practice 1153637905 Receives reassigned benefits from 3 practitioners
Practice locations: Chaska, MN
O20231212003846 MN DME Supplier - Physician - Optometrist 1153637905 Practice locations: Chaska, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pearle Vision106 Pioneer TRL, Chaska, MN 55318-1167(952) 368-2325 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Does not accept assignmentParticipating since Sep 1, 2015

National Provider Directory

National Provider Directory

Locations

15052 Gleason Path
#103
Apple Valley, MN 55124

106 Pioneer Trl
Chaska, MN 55318
Phone (952) 368-2325

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1306223151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 PIONEER TRL",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181167",
            "telephone_number": "952-368-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PIONEER TRL",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181167",
            "telephone_number": "952-368-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE VISION CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "KRIETLOW",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-368-2325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chaska, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.