Minnesota Optometric Eye Doctor, P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MINNESOTA OPTOMETRIC EYE DOCTOR, P.A.

Practice address

1752 N Frontage Rd
Hastings, MN 55033

Phone

(651) 438-2400

NPI assigned

Apr 5, 2018

Last updated

Jul 24, 2018By 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

Eric R Tyler, ODNPI 1285652826

Title

OD/Owner

Phone

(651) 206-2418

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Minnesota Optometric Eye Doctor, P.a.

  • Optometrist
  • Grand Forks, ND
  • NPI 1558972349

  8628329992

  Same PAC ID

Tax ID family

Minnesota Optometric Eye Doctor PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Minnesota Optometric Eye Doctor, P.a.

  • Optometrist
  • Grand Forks, ND
  • NPI 1558972349
  NPD tax ID

Practitioners 1

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.

• Eric Richard Tyler, O. D.

  • Optometrist
  • Wautoma, WI
  • NPI 1285652826

  MN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1316443542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 SHERRY CT",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551174639",
            "telephone_number": "651-206-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 N FRONTAGE RD",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "55033",
            "telephone_number": "651-438-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 White Bear Ave N",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091215",
            "country_code": "US",
            "telephone_number": "651-770-4274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINNESOTA OPTOMETRIC EYE DOCTOR, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "651-206-2418",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milliren Family Dentistry
• Michael R Milliren, DDS
• Millner and Loppnow P.a.
• Melissa Millner
• Scott Millner, D.C.
• Minnesota Orthodontics and Dentofacial Orthopedics PA
• Modern Dental Professionals Minnesota PC (Midwest Dental)
• Abyan A Mohamed
• Nasro Mohamed, PHARMD
• Gary A. Moody, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.