Individual provider Active NPI

Matthew William Grange, O.D.

  • Occupational Vision Optometrist
  • Eagan, MN
National Provider Identifier
1427146372
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Vision OptometristTaxonomy code 152WX0102X
License
3020000 Issued in MN
Practice address
1340 Duckwood Dr
Suite 14
Eagan, MN 55123-2324
Phone
(651) 452-0344
Fax
(651) 452-1564
NPI assigned
Oct 10, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3020000 MN
Corneal and Contact Management Optometrist 152WC0802X 3020000 MN
Pediatric Optometrist 152WP0200X 3020000 MN
Sports Vision Optometrist 152WS0006X 3020000 MN
Occupational Vision Optometrist 152WX0102X 3020000 MN Primary

Addresses

Primary practice location

1340 Duckwood Dr
Suite 14
Eagan, MN 55123-2324

Mailing address

1340 Duckwood Dr
Suite 14
Eagan, MN 55123-2324
Phone (651) 452-0344

Other identifiers 6

IdentifierTypeStateIssuer
2425242OtherAMERICAS PPO
86G79GROtherMNBLUE CROSS BLUE SHIELD
XX1901044875OtherMNPREFERRED ONE
2203255OtherMNMEDICA
HP60833OtherMNHEALTH PARTNERS
182595OtherMNUCARE

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
I20051102000418 MN Practitioner - Optometry 9739106311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of SC LLCGroup PAC ID 4587998802, 63 clinicians

Practice addresses (Care Compare)

1340 Duckwood Dr
Suite 14
Eagan, MN 55123-2324
Phone (651) 452-0344

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3020000MNMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of SC LLC Optometrist CurrentSince Feb 1, 2022 Accepting new patients
Eye Care Associates of Co LLC Optometrist Past Accepting new patients

Locations

6487 Cedar Hills Dr
Cannon Falls, MN 55009
Phone (507) 263-3949

15083 Crestone Ave W
Rosemount, MN 55068
Phone (651) 423-3300

1340 Duckwood Dr
Ste 14
Saint Paul, MN 55123
Phone (651) 349-4699

Organizations & group practices 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1427146372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 DUCKWOOD DR",
            "address_2": "SUITE 14",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232324",
            "telephone_number": "651-452-0344",
            "fax_number": "651-452-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 DUCKWOOD DR",
            "address_2": "SUITE 14",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232324",
            "telephone_number": "651-452-0344",
            "fax_number": "651-452-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGE",
        "first_name": "MATTHEW",
        "middle_name": "WILLIAM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3020000",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "3020000",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MN",
            "license": "3020000",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "MN",
            "license": "3020000",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "MN",
            "license": "3020000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAS PPO",
            "identifier": "2425242",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "86G79GR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "XX1901044875",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2203255",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP60833",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "182595",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.