Active NPI
Katie Nicole Tancabel, O.D.
- Optometrist
- Annandale, MN
National Provider Identifier
1376704940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3139
- Practice address
- 500 Elm St E
Annandale, MN 55302-1149 - Phone
- (320) 274-3701
- Fax
- (320) 274-3784
- NPI assigned
- Jun 17, 2008
- Last updated
- Feb 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 3139 | MN | Primary |
Addresses
Primary practice location
500 Elm St E
Annandale, MN 55302-1149
Mailing address
500 Elm St E
PO Box 128
Annandale, MN 55302-1149
Phone (320) 274-3701
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, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
115 Olsen Blvd NE
Suite 300
Cokato, MN 55321-4797
Phone (320) 286-5695
500 Elm St E
Annandale, MN 55302-1149
Phone (320) 274-3701
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 24 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3139 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cokato Eye Center, Inc. | Optometrist | Current | Accepting new patients |
| Annandale Eye Clinic Inc | Optometrist | Current | Accepting new patients |
| Annandale Eye Clinic Inc | Optometrist | Current | Accepting new patients |
| Visionworks Inc | Past | Accepting new patients | |
| Regional Eye Specialists LLC | Optometrist | Past | Accepting new patients |
| Vision World Inc | Past | Accepting new patients | |
| Vision World Inc | Past | Accepting new patients |
Locations
115 Olsen Blvd NE
Cokato, MN 55321
Phone (320) 286-2712
115 Olsen Blvd NE
Ste 300
Cokato, MN 55321
Phone (320) 286-5695
135 N Sibley Ave
Litchfield, MN 55355
Phone (320) 593-3100
Organizations & group practices 7
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.
-
- Optometrist
- Cokato, MN
- NPI 1245303825
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1376704940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 ELM ST E",
"address_2": "PO BOX 128",
"city": "ANNANDALE",
"state": "MN",
"postal_code": "553021149",
"telephone_number": "320-274-3701",
"fax_number": "320-274-3784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 ELM ST E",
"city": "ANNANDALE",
"state": "MN",
"postal_code": "553021149",
"telephone_number": "320-274-3701",
"fax_number": "320-274-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANCABEL",
"first_name": "KATIE",
"middle_name": "NICOLE",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-17",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annandale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.