Individual provider Active NPI

Stefanie A. Hurst, O.D.

  • Optometrist
  • Savage, MN
National Provider Identifier
1447275284
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2777 Issued in MN
Practice address
4200 County Road 42 W
Savage, MN 55378-4051
Phone
(952) 895-5434
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2777 MN Primary

Addresses

Primary practice location

4200 County Road 42 W
Savage, MN 55378-4051

Mailing address

4200 County Road 42 W
Savage, MN 55378-4051

Other identifiers 4

IdentifierTypeStateIssuer
061M9FAOtherMNBCBS
31388OtherMNHEALTH PARTNERS
407231025417OtherMNPREFERRED ONE
22-01792OtherMNMEDICA

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
I20040601000014 MN Practitioner - Optometry 1951382506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Vision Clinic, P.C.Group PAC ID 0446231096, 2 clinicians

Practice addresses (Care Compare)

4200 W County Rd
Suite 42
Savage, MN 55378-4051
Phone (952) 895-5434

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision Clinic, P.C. Optometrist CurrentSince Apr 19, 2002 Accepting new patients
Family Vision Clinic of Farmington Optometrist PastSince Nov 1, 2007 Accepting new patients
Focused Eye Care, PA Optometrist Past Accepting new patients

Locations

4200 W County Road 42
Savage, MN 55378
Phone (952) 895-5434

4200 W County Road 42
Ste 300
Savage, MN 55378

Organizations & group practices 3

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447275284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 COUNTY ROAD 42 W",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 COUNTY ROAD 42 W",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784051",
            "telephone_number": "952-895-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "STEFANIE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "061M9FA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "31388",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "407231025417",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-01792",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

Verify at the official NPI Registry.