Active NPI
Anthony Doffin, O.D.
- Optometrist
- Saint Anthony, MN
National Provider Identifier
1366520538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3004
- Practice address
- 2929 Pentagon Drive
Saint Anthony, MN 55418 - Phone
- (612) 781-4730
- Fax
- (763) 784-9627
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3004 | MN | Primary |
Addresses
Primary practice location
2929 Pentagon Drive
Saint Anthony, MN 55418
Mailing address
3026 Aspen Lake Dr NE
Blaine, MN 55449-7517
Phone (651) 747-7311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171652200 | Medicaid | MN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2929 Pentagon Dr
St Anthony, MN 55418-3208
Phone (612) 781-4730
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Anthony Optometric Clinic | Current | Accepting new patients | |
| Vision World Inc | Past | Accepting new patients | |
| Visionworks Inc | Past | Accepting new patients |
Locations
2929 Pentagon Dr
St Anthony, MN 55418
Phone (612) 781-4730
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- St Anthony, MN
- NPI 1205953437
-
- Eyewear Supplier
- Fergus Falls, MN
- NPI 1982789533
-
- Eyewear Supplier
- Omaha, NE
- NPI 1205924792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1366520538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3026 ASPEN LAKE DR NE",
"city": "BLAINE",
"state": "MN",
"postal_code": "554497517",
"telephone_number": "651-747-7311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 PENTAGON DRIVE",
"city": "SAINT ANTHONY",
"state": "MN",
"postal_code": "55418",
"telephone_number": "612-781-4730",
"fax_number": "763-784-9627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOFFIN",
"first_name": "ANTHONY",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2023-11-29",
"certification_date": "2023-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3004",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171652200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Anthony, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.