Active NPI
Scott R Telander, O.D.
- Optometrist
- Forest Lake, MN
National Provider Identifier
1437254455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2990
- Practice address
- 20 Lake St N
Suite 101
Forest Lake, MN 55025-2523 - Phone
- (651) 464-4824
- Fax
- (651) 464-0003
- NPI assigned
- Sep 14, 2006
- Last updated
- May 16, 2012
- 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 | 2990 | MN | Primary |
Addresses
Primary practice location
20 Lake St N
Suite 101
Forest Lake, MN 55025-2523
Mailing address
20 Lake St N
Suite 101
Forest Lake, MN 55025-2523
Phone (651) 464-4824
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807044000 | Medicaid | MN |
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
- Pennsylvania College of Optometry, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20 Lake St N
Suite 101
Forest Lake, MN 55025-2510
Phone (651) 464-4824
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 13 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2990 | MN | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionworks, Inc | Past | Accepting new patients | |
| Visionworks, Inc. | Optometrist | Past | Accepting new patients |
| Vision World Inc | Past | Accepting new patients |
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": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337126400000",
"number": "1437254455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 LAKE ST N",
"address_2": "SUITE 101",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252523",
"telephone_number": "651-464-4824",
"fax_number": "651-464-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 LAKE ST N",
"address_2": "SUITE 101",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252523",
"telephone_number": "651-464-4824",
"fax_number": "651-464-0003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELANDER",
"first_name": "SCOTT",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2012-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "2990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807044000",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.