Organization Active NPI

Uptown Vision Clinic, PA

  • Optometrist
  • Minneapolis, MN
National Provider Identifier
1508032574
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
UPTOWN VISION CLINIC, PA
Practice address
3553 Hennepin Ave S
Minneapolis, MN 55408-3830
Phone
(612) 822-5844
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Dr. Thomas J AugustinNPI 1275845711
Title
OD
Phone
(612) 822-5844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3553 Hennepin Ave S
Minneapolis, MN 55408-3830

Mailing address

3553 Hennepin Ave S
Minneapolis, MN 55408-3830

Other names 1

  • Uptown Vision Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170505001145 MN Part B Supplier - Clinic/Group Practice 4688951353 Receives reassigned benefits from 2 practitioners
Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory

Locations

3553 Hennepin Ave
Minneapolis, MN 55408
Phone (612) 822-5844

Practitioners & affiliated clinicians

Practitioners 3

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": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1508032574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 HENNEPIN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3553 HENNEPIN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083830",
            "telephone_number": "612-822-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN VISION CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2025-09-02",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "AUGUSTIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "612-822-5844",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Uptown Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.