Dr. Petronack & Associates, Optometrists, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2544 Issued in MN

Legal business name

DR. PETRONACK & ASSOCIATES, OPTOMETRISTS, INC.

Doing business as

Hugo Optical

Practice address

5679 147TH St N
Hugo, MN 55038-9302

Phone

(651) 762-9545

Fax

(651) 762-9542

NPI assigned

May 14, 2007

Last updated

Jul 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Stephen Petronack, O.D.NPI 1295891596

Title

President

Phone

(651) 762-9545

Specialties & licenses 1

Addresses

Other names 1

• Hugo Optical Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael S Petronack, O.D.

  • Optometrist
  • Hugo, MN
  • NPI 1295891596
  Authorized official Same address or phone

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1578778296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5679 147TH ST N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550389302",
            "telephone_number": "651-762-9545",
            "fax_number": "651-762-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5679 147TH ST N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550389302",
            "telephone_number": "651-762-9545",
            "fax_number": "651-762-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PETRONACK & ASSOCIATES, OPTOMETRISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "PETRONACK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-762-9545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hugo Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.