Active NPI
Steven Todd Exsted, O.D.
- Optometrist
- Monticello, MN
National Provider Identifier
1538276258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3015
- Practice address
- 9320 Cedar St
Monticello, MN 55362-4522 - Phone
- (763) 295-9817
- Fax
- (763) 295-9819
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3015 | MN | Primary |
Addresses
Primary practice location
9320 Cedar St
Monticello, MN 55362-4522
Mailing address
3567 144TH St NW
Monticello, MN 55362-6247
Phone (763) 295-9817
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050913000492 | MN | Practitioner - Optometry | 3577596360 | Practice locations: Monticello, MN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3015 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1538276258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3567 144TH ST NW",
"city": "MONTICELLO",
"state": "MN",
"postal_code": "553626247",
"telephone_number": "763-295-9817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9320 CEDAR ST",
"city": "MONTICELLO",
"state": "MN",
"postal_code": "553624522",
"telephone_number": "763-295-9817",
"fax_number": "763-295-9819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EXSTED",
"first_name": "STEVEN",
"middle_name": "TODD",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.