MSP Family Eye Clinic, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2820 Issued in MN

Legal business name

MSP FAMILY EYE CLINIC, LLC

Practice address

4848 County Road 101
Minnetonka, MN 55345-2635

Phone

(952) 401-9202

NPI assigned

Sep 9, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Max Kostecki, O.D.

Title

President

Phone

(952) 401-9202

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1508267543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4848 COUNTY ROAD 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452635",
            "telephone_number": "952-401-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 COUNTY ROAD 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452635",
            "telephone_number": "952-401-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSP FAMILY EYE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "KOSTECKI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "MAX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-401-9202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siri Gene Mossing
• Bethany Joy Motley, RD
• Mai Moua
• James Stephen Moy, MD
• Darrell Kenneth Moyer, CRNA
• Kilea Linnet Mudaliar, ARNP
• Alexandra A Mueller, MSW, LICSW
• Tia Mueller, MS, CCC-SLP
• Jessica Rae Muench, DC
• Laura Jo Muench, LICSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.