Individual provider Active NPI

Steven P Jeppson, O.D.

  • Optometrist
  • Saint James, MN
National Provider Identifier
1366515272
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1704 Issued in MN
Practice address
517 1St Ave S
Saint James, MN 56081-1727
Phone
(507) 375-4941
Fax
(507) 375-3610
NPI assigned
Nov 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1704 MN Primary

Addresses

Primary practice location

517 1St Ave S
Saint James, MN 56081-1727

Mailing address

517 1St Ave S
PO Box 110
Saint James, MN 56081-1727
Phone (507) 375-4941

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050119000770 MN Practitioner - Optometry 4385693191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of SC LLCGroup PAC ID 4587998802, 63 clinicians

Practice addresses (Care Compare)

517 1St Ave S
Saint James, MN 56081-1727
Phone (507) 375-3737

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1704MNMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of SC LLC Optometrist CurrentSince Mar 11, 2022 Accepting new patients
Dr. T.a. Pinke, Inc Optometrist Past Accepting new patients

Locations

435 S Grove St
Ste 2
Blue Earth, MN 56013
Phone (507) 235-5323

6487 Cedar Hills Dr
Cannon Falls, MN 55009
Phone (507) 263-3949

517 1st Ave S
Saint James, MN 56081
Phone (507) 375-3737

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366515272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 1ST AVE S",
            "address_2": "PO BOX 110",
            "city": "SAINT JAMES",
            "state": "MN",
            "postal_code": "560811727",
            "telephone_number": "507-375-4941",
            "fax_number": "507-375-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 1ST AVE S",
            "city": "SAINT JAMES",
            "state": "MN",
            "postal_code": "560811727",
            "telephone_number": "507-375-4941",
            "fax_number": "507-375-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPSON",
        "first_name": "STEVEN",
        "middle_name": "P",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint James, MN

Sources for this page

Verify at the official NPI Registry.