Kaitlyn Jo Marshall, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3723 Issued in MN

Practice address

7789 147TH St W
Apple Valley, MN 55124-7568

Phone

(952) 432-0680

Fax

(952) 432-8823

NPI assigned

Mar 26, 2020

Last updated

Mar 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagan Eye Clinic LLCGroup PAC ID 0345220745, 48 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drkaitlyn@eyeclinicdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eagan Eye Clinic LLC

  • Optometrist
  • Eagan, MN
  • NPI 1477732337
  Medicare reassignment Care Compare group NPD
• Apple Valley Eye Care P.a.

  dba Apple Valley Eye Care

  • Optometrist
  • Apple Valley, MN
  • NPI 1669664835
  Medicare reassignment NPD
• Eagan Eye Clinic LLC

  • Optometrist
  • Becker, MN
  • NPI 1023615069
  NPD

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1316574478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7789 147TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247568",
            "telephone_number": "952-432-0680",
            "fax_number": "952-432-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7789 147TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247568",
            "telephone_number": "952-432-0680",
            "fax_number": "952-432-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KAITLYN",
        "middle_name": "JO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Lee Mahlum, PA-C
• Making the Connection
• Brandon Mannie, D.C.
• Jennifer Lynn Mannie, LADC
• Marietta Hoogs, PHD, PLLC
• Natalie Martinek, LADC
• Nathan Martinez, DPT, PT
• Rachel Martonik, OTR/L
• Sravya Maru
• Jeffrey James Mathiason, DDS

• Optometrist in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.