Individual provider Active NPI

Sarah Grace Watson, OD

  • Optometrist
  • Maplewood, MN
National Provider Identifier
1396504304
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3911 Issued in MN
Practice address
3001 White Bear Ave N Ste 1050
Maplewood, MN 55109-1290
Phone
(651) 770-3923
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3911 MN Primary

Addresses

Primary practice location

3001 White Bear Ave N Ste 1050
Maplewood, MN 55109-1290

Mailing address

3001 White Bear Ave N Ste 1050
Maplewood, MN 55109-1283
Phone (651) 770-3923

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516002114 MN Practitioner - Optometry 8426499831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace Vision IncGroup PAC ID 8022247998, 4 clinicians

Practice addresses (Care Compare)

3001 White Bear Ave N
Suite 1050
Maplewood, MN 55109-1283
Phone (315) 442-4485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Vision, Inc. Optometrist CurrentSince Apr 2, 2024 Accepting new patients

Locations

3001 White Bear Ave N
Ste 1050
Saint Paul, MN 55109
Phone (315) 442-4485

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1396504304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 WHITE BEAR AVE N STE 1050",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091283",
            "telephone_number": "651-770-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WHITE BEAR AVE N STE 1050",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091290",
            "telephone_number": "651-770-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SARAH",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.