Individual provider Active NPI

Jarrod Allen Nelson, O.D.

  • Optometrist
  • North Branch, MN
National Provider Identifier
1487785499
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2410 Issued in MN
Practice address
5366 386TH St NE
North Branch, MN 55056-5833
Phone
(651) 674-6844
NPI assigned
Mar 8, 2007
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2410 MN Primary

Addresses

Primary practice location

5366 386TH St NE
North Branch, MN 55056-5833

Mailing address

1479 485TH St W
Stanchfield, MN 55080-4216
Phone (763) 691-8252

Other identifiers 6

IdentifierTypeStateIssuer
159371OtherMNEYEMED
22-02649OtherMNMEDICA
817S9NEOtherMNBLUE CROSS BLUE SHIELD
HP28522OtherMNHEALTH PARTNERS
552025800MedicaidMN
916771028513OtherMNPREFERRED ONE

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
I20040401001703 MN Practitioner - Optometry 4082606660 Reassigns benefits to 1 organization
Practice locations: North Branch, MN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Eye Care LLCGroup PAC ID 8022075142, 6 clinicians

Practice addresses (Care Compare)

5366 386TH St NE
North Branch, MN 55056-5833
Phone (651) 674-6844

Merit-based Incentive Payment System (MIPS)

Final score
91.34 of 100Reported as group
Quality
95.62
Improvement activities
40
Cost
76.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5410MNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Eye Care LLC Optometrist CurrentSince Jun 8, 2022 Accepting new patients
Total Eye Care LLC Optometrist CurrentSince Jun 8, 2022 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

11725 Stinson Ave
Chisago City, MN 55013
Phone (651) 257-8421

5366 386th St NE
North Branch, MN 55056
Phone (651) 674-6800

26263 Forest Blvd
#300
Wyoming, MN 55092
Phone (651) 982-7720

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1487785499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 485TH ST W",
            "city": "STANCHFIELD",
            "state": "MN",
            "postal_code": "550804216",
            "telephone_number": "763-691-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5366 386TH ST NE",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550565833",
            "telephone_number": "651-674-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JARROD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "159371",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-02649",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "817S9NE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP28522",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "552025800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "916771028513",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Branch, MN

Sources for this page

Verify at the official NPI Registry.