NPIMap

Organization Active NPI

Fischer Laser Eye Center LLC

  • Optometrist
  • Montevideo, MN
National Provider Identifier
1477034312
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FISCHER LASER EYE CENTER LLC
Practice address
629 Legion Dr Ste 2
Montevideo, MN 56265-1729
Phone
(320) 321-1611
Fax
(320) 321-1612
NPI assigned
Aug 28, 2018
Organization subpart
Yes
Parent organization
FISCHER LASER EYE CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Authorized official

Name
Valerie J Selness
Title
Practice Manager
Phone
(320) 235-2020

Specialties & licenses 1

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

Addresses

Primary practice location

629 Legion Dr Ste 2
Montevideo, MN 56265-1729

Mailing address

1801 19TH Ave SW
Willmar, MN 56201-4946
Phone (320) 235-2020

Other names 1

  • Family Eye Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040109000216 MN Part B Supplier - Clinic/Group Practice 6406756295 Receives reassigned benefits from 9 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New London, MN; Willmar, MN; Redwood Falls, MN; Paynesville, MN; Olivia, MN; Montevideo, MN; Litchfield, MN

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Family Eye Center

Locations

1805 Minnesota Ave
Ste 2
Benson, MN 56215
Phone (320) 842-3221

61 Main St S
New London, MN 56273
Phone (320) 354-2020

37 Central Ave E
New London, MN 56273
Phone (320) 354-2020

115 Washburne Ave
Paynesville, MN 56362
Phone (320) 243-2020

812 1st St S
Willmar, MN 56201
Phone (320) 235-2020

Practitioners & affiliated clinicians

Practitioners 9

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": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1477034312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014946",
            "telephone_number": "320-235-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 LEGION DR STE 2",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651729",
            "telephone_number": "320-321-1611",
            "fax_number": "320-321-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISCHER LASER EYE CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FISCHER LASER EYE CENTER LLC",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "SELNESS",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "320-235-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montevideo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.