Patrick J Martin

Primary specialty

OptometristTaxonomy code 152W00000X

License

2093 Issued in MN

Practice address

Pearle Vision
1056 Burnsville Center
Burnsville, MN 55306

Phone

(952) 435-8821

Fax

(952) 435-1624

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Sirius Vision Optical Inc

  • Optometrist
  • Burnsville, MN
  • NPI 1780023879
  Medicare reassignment NPD Authorized official
• Sirius Vision Optometry PC

  • Optometrist
  • Burnsville, MN
  • NPI 1336588177
  Medicare reassignment Authorized official
• Double Image, Inc

  • Durable Medical Equipment & Medical Supplies
  • Saint Paul, MN
  • NPI 1477624252
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)
• Pearle Vision Inc

  • Eyewear Supplier
  • Fairview Heights, IL
  • NPI 1982744033
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1356437065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 S SUTTON LAKE BLVD",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553529467",
            "telephone_number": "952-492-3915",
            "fax_number": "952-435-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEARLE VISION",
            "address_2": "1056 BURNSVILLE CENTER",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55306",
            "telephone_number": "952-435-8821",
            "fax_number": "952-435-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PATRICK",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3C309MA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "549023500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED / COLE VISION",
            "identifier": "911361",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Ruth Marsh, CNP
• Genesis Lynn Marshall
• Donna Louise Martin-Wallace, LPCC, LADC, ADCR-MN
• Angela Jeanine Martin, RN
• Jaime Ellen Kuper Martin, MA CCC-SLP
• Amy Martinez, PT
• Marty-McDonald Health Services, P.a.
• Ikran Maruf
• Ishwaq Maruf
• Isabella Marullo

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.