Individual provider Active NPI

Amanda Ann Pojanowski, O.D.

  • Optometrist
  • Richfield, MN
National Provider Identifier
1528310869
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3424 Issued in MN
Practice address
6625 Lyndale Ave S Ste 300
Richfield, MN 55423-2491
Phone
(612) 243-8999
Fax
(612) 869-3473
NPI assigned
Oct 10, 2012
Last updated
Mar 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3424 MN Primary

Addresses

Primary practice location

6625 Lyndale Ave S Ste 300
Richfield, MN 55423-2491

Mailing address

6625 Lyndale Ave S Ste 300
Richfield, MN 55423-2491
Phone (612) 243-8999

Other practice location 1

1502 Woodlane Dr
Woodbury, MN 55125-2221
Phone (651) 735-9550

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
I20160502000002 MN Practitioner - Optometry 6507165255 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
In House Senior Services LLCGroup PAC ID 7113170267, 16 clinicians

Practice addresses (Care Compare)

6625 Lyndale Ave S
Suite 105
Richfield, MN 55423-2673
Phone (612) 243-8999

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3424MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
In House Senior Services, LLC Optometrist CurrentSince Apr 1, 2019 Accepting new patients
Wallerich Eye Care LLC Dba Swoop Eye Care Optometrist CurrentSince Aug 15, 2021 Accepting new patients
Optometric Services, LLC Optometrist CurrentSince Apr 21, 2016 Accepting new patients

Locations

6625 Lyndale Ave S
Ste 105
Richfield, MN 55423
Phone (612) 200-8029

6625 Lyndale Ave S
Ste 300
Richfield, MN 55423
Phone (612) 243-8999

817 E 66th St
Richfield, MN 55423
Phone (612) 488-1566

1300 University Ave W
Saint Paul, MN 55104
Phone (651) 642-1146

1980 Robert St S
West Saint Paul, MN 55118
Phone (651) 451-1805

1891 Robert St S
West St Paul, MN 55118
Phone (651) 451-1805

Organizations & group practices 4

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": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1528310869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-243-8999",
            "fax_number": "612-869-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-243-8999",
            "fax_number": "612-869-3473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1502 Woodlane Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551252221",
            "country_code": "US",
            "telephone_number": "651-735-9550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POJANOWSKI",
        "first_name": "AMANDA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.