Organization Active NPI

Goldsmith Eye Care PC

  • Optometrist
  • New Prague, MN
National Provider Identifier
1609128545
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GOLDSMITH EYE CARE PC
Practice address
112 Main St E
New Prague, MN 56071-2440
Phone
(952) 758-2080
Fax
(952) 758-5922
NPI assigned
Oct 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Wendy Ann Goldsmith, ODNPI 1710972955
Title
Cfo
Phone
(952) 758-2080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

112 Main St E
New Prague, MN 56071-2440

Mailing address

PO Box 261
New Prague, MN 56071-0261
Phone (952) 758-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140303000071 MN Part B Supplier - Clinic/Group Practice 3173753670 Receives reassigned benefits from 7 practitioners
Practice locations: Prior Lake, MN; New Prague, MN; Gaylord, MN
O20141028002519 MN DME Supplier - Physician - OptometristDME Supplier - Optician 3173753670 Practice locations: New Prague, MN

National Provider Directory

National Provider Directory

Locations

112 Main St E
New Prague, MN 56071
Phone (952) 758-2080

15875 Franklin Trl SE
Ste 111
Prior Lake, MN 55372

1127 Shakopee Town Sq
Shakopee, MN 55379
Phone (855) 480-4742

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1609128545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560710261",
            "telephone_number": "952-758-2080",
            "fax_number": "952-758-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MAIN ST E",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560712440",
            "telephone_number": "952-758-2080",
            "fax_number": "952-758-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDSMITH EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "952-758-2080",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Prague, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.