Active NPI
Kristen Kingsbury Desautel, O.D.
- Optometrist
- Oak Park Heights, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3201
- Practice address
- 5980 Neal Ave N Ste 500
Oak Park Heights, MN 55082-2195 - Phone
- (651) 998-2020
- Fax
- (651) 342-1407
- NPI assigned
- Jun 30, 2010
- Last updated
- Dec 12, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 3201 | MN | Primary |
Addresses
Primary practice location
5980 Neal Ave N Ste 500
Oak Park Heights, MN 55082-2195
Mailing address
5980 Neal Ave N Ste 500
Oak Park Heights, MN 55082-2195
Phone (651) 998-2020
Other names 1
- Kristen Anne Kingsbury
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
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5980 Near Ave N
Suite 500
Oak Park Height, MN 55082-2195
Phone (651) 998-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3249 | WI | MD | Dentist |
| 3201 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KB Vision LLC | Current | Accepting new patients | |
| Sees the Day LTD | Optometrist | Current | Accepting new patients |
| Sees the Day LTD | Optometrist | Current | Accepting new patients |
| Visionworks Inc | Past | Accepting new patients | |
| Vision World Inc | Past | Accepting new patients | |
| Vision World Inc | Past | Accepting new patients |
Locations
1757 N Frontage Rd
Hastings, MN 55033
Phone (651) 480-8515
5980 Neal Ave N
Ste 500
Oak Park Heights, MN 55082
Phone (651) 208-1389
7150 Valley Creek Plz
Ste 216
Woodbury, MN 55125
Phone (651) 738-4886
113 Carmichael Rd
Hudson, WI 54016
Phone (715) 377-7970
Organizations & group practices 6
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": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702339200000",
"number": "1578874814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5980 NEAL AVE N STE 500",
"city": "OAK PARK HEIGHTS",
"state": "MN",
"postal_code": "550822195",
"telephone_number": "651-998-2020",
"fax_number": "651-342-1407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5980 NEAL AVE N STE 500",
"city": "OAK PARK HEIGHTS",
"state": "MN",
"postal_code": "550822195",
"telephone_number": "651-998-2020",
"fax_number": "651-342-1407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAUTEL",
"first_name": "KRISTEN",
"middle_name": "KINGSBURY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2023-12-12",
"certification_date": "2023-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "KINGSBURY",
"middle_name": "ANNE",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Oak Park Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.