Organization Active NPI

Snyder Vision Optometrists PLLC

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1407088305
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2880 Issued in MN
Legal business name
SNYDER VISION OPTOMETRISTS PLLC
Practice address
757 Cleveland Ave S
Saint Paul, MN 55116-1302
Phone
(651) 699-5400
NPI assigned
Aug 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Authorized official

Name
Dr. Brian J Snyder, O.D.NPI 1609871557
Title
Owner
Phone
(612) 619-6038

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2880 MN Primary

Addresses

Primary practice location

757 Cleveland Ave S
Saint Paul, MN 55116-1302

Mailing address

757 Cleveland Ave S
Saint Paul, MN 55116-1302
Phone (651) 699-5400

Other names 1

  • Highland Family Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100127000920 MN Part B Supplier - Clinic/Group Practice 5092857169 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

757 Cleveland Ave S
Saint Paul, MN 55116
Phone (651) 699-1547

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1407088305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 CLEVELAND AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161302",
            "telephone_number": "651-699-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 CLEVELAND AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161302",
            "telephone_number": "651-699-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNYDER VISION OPTOMETRISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-12",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-619-6038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.