NPIMap

Organization Active NPI

JJS Optical LLC

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1316010218
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MN1582 Issued in MN
Legal business name
JJS OPTICAL LLC
Practice address
101 5TH St E Ste 281
Saint Paul, MN 55101-1862
Phone
(651) 227-6506
Fax
(651) 227-6507
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Authorized official

Name
Mr. James Edward JohnsonNPI 1386883254
Title
President
Phone
(651) 227-6506

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 MN1582 MN Primary

Addresses

Primary practice location

101 5TH St E Ste 281
Saint Paul, MN 55101-1862

Mailing address

101 5TH St E Ste 281
Saint Paul, MN 55101-1862
Phone (651) 227-6506

Other identifiers 3

IdentifierTypeStateIssuer
165105600MedicaidMN
021823500MedicaidMN
869675600MedicaidMN

Other names 1

  • Metro Optics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050106000886 MN Part B Supplier - Clinic/Group Practice 4183672041 Receives reassigned benefits from 2 practitioners
Practice locations: Roseville, MN; Saint Paul, MN

National Provider Directory

National Provider Directory
Tax ID family
JJS Optical LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

101 5th St E
Ste 281
Saint Paul, MN 55101
Phone (651) 227-6506

1605 County Road C W
Saint Paul, MN 55113
Phone (651) 631-8112

Practitioners & affiliated clinicians

Practitioners 7

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1316010218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 5TH ST E STE 281",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011862",
            "telephone_number": "651-227-6506",
            "fax_number": "651-288-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 5TH ST E STE 281",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011862",
            "telephone_number": "651-227-6506",
            "fax_number": "651-227-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJS OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-227-6506",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN1582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165105600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021823500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "869675600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Optics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.