John Joseph Perszyk, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2005 Issued in MN

Practice address

12577 Wayzata Blvd
Pearle Express / Ridgedale
Minnetonka, MN 55305-1938

Phone

(952) 546-4414

Fax

(952) 541-0831

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

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, 1984

Medicare assignment

May accept Medicare assignment

Group practices

I M I S Minnesota IncGroup PAC ID 9335268754, 4 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• I M I S Minnesota Inc

  dba Pearle Vision

  • Optometrist
  • Minnetonka, MN
  • NPI 1043353949
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366529547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12577 WAYZATA BLVD",
            "address_2": "PEARLE EXPRESS / RIDGEDALE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051938",
            "telephone_number": "952-546-4414",
            "fax_number": "952-541-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12577 WAYZATA BLVD",
            "address_2": "PEARLE EXPRESS / RIDGEDALE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051938",
            "telephone_number": "952-546-4414",
            "fax_number": "952-541-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSZYK",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Pennicooke, NP
• Hannah Carraway Peptis, FNP
• Renee Perrone
• Jane Marie Perry, LICSW
• Jessica Perry
• Perzhu Construction LLC
• Ariana Peterson, OTR
• Caitlin Marie Peterson
• Debra J Peterson, RN, CFNP
• Gretchen Elsa Peterson, LICSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.