Conroy Eye Care PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2118 Issued in MN

Legal business name

CONROY EYE CARE PC

Practice address

1011 Broadway
Wheaton, MN 56296-1303

Phone

(320) 563-4610

Fax

(320) 563-4657

NPI assigned

May 15, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Allen Conroy, ODNPI 1144219213

Title

Owner President

Phone

(320) 563-4610

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Conroy Eye Care PC

  • Optometrist
  • Milbank, SD
  • NPI 1063479426

  2365425196

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Conroy Eye Care PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Conroy Eye Care PC

  • Optometrist
  • Milbank, SD
  • NPI 1063479426
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Allen Conroy, OD

  • Optometrist
  • Milbank, SD
  • NPI 1144219213

  MN

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1477720795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BROADWAY",
            "city": "WHEATON",
            "state": "MN",
            "postal_code": "562961303",
            "telephone_number": "320-563-4610",
            "fax_number": "320-563-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BROADWAY",
            "city": "WHEATON",
            "state": "MN",
            "postal_code": "562961303",
            "telephone_number": "320-563-4610",
            "fax_number": "320-563-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROY EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "320-563-4610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358723100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4645120001",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Bryan, MD, MSC
• Carol Burke, PT
• City of Wheaton (Wheaton Community Hospital)
• City of Wheaton (Wheaton Community Hospital)
• City of Wheaton
• Dozak Drug LLC (Wheaton Drug and Gifts)
• Joshua Dozak, PHARMD
• Fergus Falls Medical Group, P.a.
• Alan B. Hodenfield, O.T.
• Amy M. Hodenfield, O.T.

• Optometrist in Wheaton, MN
• Providers in Wheaton, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.