Individual provider Active NPI

Yukiko Oda, O.D.

  • Optometrist
  • Excelsior, MN
National Provider Identifier
1588929863
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3492 Issued in MN
Practice address
400 Water St Ste 105
Excelsior, MN 55331-3001
Phone
(937) 418-7271
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6151 OH
Optometrist 152W00000X 3492 MN Primary

Addresses

Primary practice location

400 Water St Ste 105
Excelsior, MN 55331-3001

Mailing address

400 Water St Ste 105
Excelsior, MN 55331-3001
Phone (937) 418-7271

Other identifiers 1

IdentifierTypeStateIssuer
0071995MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150401000565 OH Practitioner - Optometry 7517284581
I20190315000310 MN Practitioner - Optometry 7517284581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionary Eye Care PAGroup PAC ID 9032455936, 13 clinicians

Practice addresses (Care Compare)

7000 York Ave S
Edina, MN 55435-4213
Phone (952) 922-8118

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6151OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Eye Care, PA Optometrist CurrentSince Jul 27, 2022 Accepting new patients
Oda Eye Care, L.L.C. Optometrist Current Accepting new patients

Locations

810 County Road 42 W
Burnsville, MN 55337
Phone (952) 236-3003

11990 Business Park Blvd N
Champlin, MN 55316
Phone (763) 354-1006

851 W 78th St
Chanhassen, MN 55317
Phone (952) 252-1208

400 Water St
Ste 105
Excelsior, MN 55331
Phone (320) 247-2139

18275 Kenrick Ave
Lakeville, MN 55044
Phone (952) 892-0028

7000 York Ave S
Minneapolis, MN 55435
Phone (952) 922-8118

15800 87th St NE
Otsego, MN 55330
Phone (763) 252-1316

6445 Richfield Pkwy
Richfield, MN 55423
Phone (612) 243-0201

21615 S Diamond Lake Rd
Rogers, MN 55374
Phone (763) 428-4831

14333 Highway 13 S
Savage, MN 55378
Phone (952) 226-1411

8900 Highway 7
St Louis Park, MN 55426
Phone (952) 933-4858

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1588929863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WATER ST STE 105",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553313001",
            "telephone_number": "937-418-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WATER ST STE 105",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553313001",
            "telephone_number": "937-418-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODA",
        "first_name": "YUKIKO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6151",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071995",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior, MN

Sources for this page

Verify at the official NPI Registry.