Active NPI
Eric Jack-Mun Bohjanen, O.D.
- Optometrist
- Duluth, MN
National Provider Identifier
1477512697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3420
- Practice address
- 2106 London Rd
Duluth, MN 55812-2127 - Phone
- (218) 522-4645
- Fax
- (218) 481-7811
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 3420 | MN | |
| Eyewear Supplier | 332H00000X | 3420 | MN | |
| Optometrist | 152W00000X | 3420 | MN | Primary |
Addresses
Primary practice location
2106 London Rd
Duluth, MN 55812-2127
Mailing address
2106 London Rd
Duluth, MN 55812-2127
Phone (218) 522-4645
Other practice location 1
2145 Academy Cir
Colorado Springs, CO 80909-1658
Phone (719) 574-7000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477512697 | Medicaid | MN | |
| H400321094 | Other | MN | INDIVIDUAL PTAN |
Other names 1
- Eric J Bohjanen
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160829003290 | MN | Practitioner - Optometry | 4082649157 | 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
Practice addresses (Care Compare)
2106 London Rd
Duluth, MN 55812-2127
Phone (218) 522-4645
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3420 | MN | MD | Optician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1477512697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2106 LONDON RD",
"city": "DULUTH",
"state": "MN",
"postal_code": "558122127",
"telephone_number": "218-522-4645",
"fax_number": "218-481-7811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2106 LONDON RD",
"city": "DULUTH",
"state": "MN",
"postal_code": "558122127",
"telephone_number": "218-522-4645",
"fax_number": "218-481-7811"
}
],
"practiceLocations": [
{
"address_1": "2145 Academy Cir",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809091658",
"country_code": "US",
"telephone_number": "719-574-7000",
"fax_number": "719-597-1712",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOHJANEN",
"first_name": "ERIC",
"middle_name": "JACK-MUN",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "MN",
"license": "3420",
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "MN",
"license": "3420",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3420",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477512697",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL PTAN",
"identifier": "H400321094",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ERIC",
"last_name": "BOHJANEN",
"middle_name": "J",
"credential": "O.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.