Active NPI
Michael Hanson
- Optometrist
- Apple Valley, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3612
- Practice address
- 15052 Gleason Path Ste 104
Apple Valley, MN 55124-7199 - Phone
- (952) 432-5889
- Fax
- (952) 432-1878
- NPI assigned
- May 24, 2019
- Last updated
- Nov 14, 2023
- 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 | 3612 | MN | Primary |
Addresses
Primary practice location
15052 Gleason Path Ste 104
Apple Valley, MN 55124-7199
Mailing address
106 Pioneer TRL
Chaska, MN 55318-1167
Phone (952) 368-2325
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3612 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenway Vision, Inc | Optometrist | Current | Accepting new patients |
| Complete Vision Care, Inc. | Optometrist | Current | Accepting new patients |
| Minnesota Optical LLC | Optometrist | Current | Accepting new patients |
| Minnesota Optical LLC | Current | Accepting new patients |
Locations
15052 Gleason Path
Ste 103
Apple Valley, MN 55124
Phone (952) 432-5889
106 Pioneer Trl
Chaska, MN 55318
Phone (952) 368-2325
19576 Holt St NW
Elk River, MN 55330
Phone (763) 241-2083
3252 W Lake St
Ste A
Minneapolis, MN 55416
Phone (612) 926-2878
3333 Hazelton Rd
Minneapolis, MN 55435
Phone (952) 926-6149
Organizations & group practices 4
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": "1558656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1396302345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 PIONEER TRL",
"city": "CHASKA",
"state": "MN",
"postal_code": "553181167",
"telephone_number": "952-368-2325",
"fax_number": "952-368-2328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15052 GLEASON PATH STE 104",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551247199",
"telephone_number": "952-432-5889",
"fax_number": "952-432-1878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-24",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.