Advanced Eyecare of Minnesota P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

MN1980 Issued in MN

Legal business name

ADVANCED EYECARE OF MINNESOTA P.A.

Practice address

2210 Highway 29 S
Alexandria, MN 56308-3487

Phone

(218) 639-0343

Fax

(218) 824-0020

NPI assigned

Jan 25, 2016

Last updated

Jan 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kay Gunnarson

Title

Manager/Owner

Phone

(218) 639-0343

Specialties & licenses 1

Addresses

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, and the practitioner matching its NPPES authorized official.

• Jenna Kay Backowski, O.D.

  • Optometrist
  • Alexandria, MN
  • NPI 1831502244
  Medicare reassignment NPD
• Lamar Wayne Gunnarson, OD

  • Optometrist
  • Alexandria, MN
  • NPI 1336137256
  Medicare reassignment NPD
• Scott Minnerath, OD

  • Optometrist
  • Alexandria, MN
  • NPI 1336719475
  Medicare reassignment NPD

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1316304124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 HAWKINS DR",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 HIGHWAY 29 S",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083487",
            "telephone_number": "218-639-0343",
            "fax_number": "218-824-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYECARE OF MINNESOTA P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "GUNNARSON",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "218-639-0343"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN1980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Activecare Chiropractic
• Sara Adams
• Nicole M Addison, CNP
• Breanna Adelman, SLP
• Advance Orthotics & Prosthetics
• Advantage Rehab Inc
• Kaylyn Ahrendt, LICSW
• Ellen Grace Aigner
• Isam M Alakhras, MD
• Alex Assisted Living LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.