NPIMap

Organization Active NPI

Brokea Inc.

Doing business as Pearle Vision

  • Optometrist
  • Maple Grove, MN
National Provider Identifier
1346453735
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BROKEA INC.
Doing business as
Pearle Vision
Practice address
13195 Weaver Lake Rd
Maple Grove, MN 55369-9410
Phone
(763) 420-5112
Fax
(763) 420-6957
NPI assigned
May 8, 2007
Last updated
Sep 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Jim Hawley
Title
Owner
Phone
(763) 420-5112

Specialties & licenses 1

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

Addresses

Primary practice location

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410

Mailing address

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410
Phone (763) 420-5112

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
O20120302000131 MN DME Supplier - OpticianDME Supplier - Physician - Optometrist 9537328075 Practice locations: Maple Grove, MN
O20120405000013 MN Part B Supplier - Clinic/Group Practice 9537328075 Receives reassigned benefits from 17 practitioners
Practice locations: Maple Grove, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1346453735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "763-420-5112",
            "fax_number": "763-420-6957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "763-420-5112",
            "fax_number": "763-420-6957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "HAWLEY",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-420-5112"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.