Active NPI
Charles Joseph Kopp, OD
- Optometrist
- Blaine, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3384
- Practice address
- 10961 Club West Pkwy
Suite 130
Blaine, MN 55449-5866 - Phone
- (763) 571-7550
- Fax
- (763) 253-4142
- NPI assigned
- Jun 4, 2014
- Last updated
- Jun 4, 2014
- 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 | 3384 | MN | Primary |
Addresses
Primary practice location
10961 Club West Pkwy
Suite 130
Blaine, MN 55449-5866
Mailing address
11314 Davenport Cir NE
Unit D
Blaine, MN 55449-4485
Phone (651) 303-6826
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
- Illinois College of Optometry at Chicago, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11091 Ulysses St NE
Suite 300
Blaine, MN 55434-4238
Phone (763) 421-9410
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.11 of 100
- Quality
- 73.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 60.18
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.34 of 100
- Quality
- 95.62
- Improvement activities
- 40
- Cost
- 76.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3384 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Eye Care LLC | Optometrist | Current | Accepting new patients |
| Minnesota Eye Consultants, PA | Current | Accepting new patients | |
| Total Eye Care LLC | Optometrist | Current | Accepting new patients |
| Northwest Eye Clinic, LLC | Past | Accepting new patients | |
| Minnesota Eye Laser & Surgery Centers, LLC | Past | Accepting new patients | |
| Minnesota Eye Consultants, PA | Past | Accepting new patients |
Locations
10961 Club West Pkwy
Ste 130
Blaine, MN 55449
Phone (763) 571-7550
11091 Ulysses St NE
Ste 300
Blaine, MN 55434
Phone (763) 421-9410
11725 Stinson Ave
Chisago City, MN 55013
Phone (651) 257-8421
9801 DuPont Ave S
Ste 200
Minneapolis, MN 55431
9801 DuPont Ave S
Ste 425
Minneapolis, MN 55431
Phone (952) 567-6092
12501 Whitewater Dr
Ste 310
Minnetonka, MN 55343
7125 Tamarack Rd
Ste 100
Woodbury, MN 55125
5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611
Interoperability endpoints
- ckopp@uvpmec.intellechartdirect.net
Organizations & group practices 6
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.
-
- Ophthalmology Physician
- Bloomington, MN
- NPI 1508839879
-
- Ophthalmology Physician
- Minnetonka, MN
- NPI 1932173374
-
- Ambulatory Surgical Clinic/Center
- Woodbury, MN
- NPI 1578003208
-
- Ophthalmology Physician
- St Anthony, MN
- NPI 1255417002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401840000000",
"number": "1366855629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11314 DAVENPORT CIR NE",
"address_2": "UNIT D",
"city": "BLAINE",
"state": "MN",
"postal_code": "554494485",
"telephone_number": "651-303-6826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10961 CLUB WEST PKWY",
"address_2": "SUITE 130",
"city": "BLAINE",
"state": "MN",
"postal_code": "554495866",
"telephone_number": "763-571-7550",
"fax_number": "763-253-4142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPP",
"first_name": "CHARLES",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-04",
"last_updated": "2014-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blaine, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.