Individual provider Active NPI

Erin M Dunphy, OD

  • Optometrist
  • Rogers, MN
National Provider Identifier
1609360098
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3569 Issued in MN
Practice address
13900 Northdale Blvd
Rogers, MN 55374
Phone
(763) 428-3757
Fax
(763) 428-9820
NPI assigned
Jun 19, 2018
Last updated
Dec 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3569 MN Primary

Addresses

Primary practice location

13900 Northdale Blvd
Rogers, MN 55374

Mailing address

13900 Northdale Blvd
Rogers, MN 55374-9627
Phone (847) 209-3231

Other practice location 1

213 Valley Dr
Oakwood Hills, IL 60013-1130
Phone (847) 209-3231

Other practice location 2

1 Central Ave W Ste 104
Saint Michael, MN 55376-4590
Phone (763) 497-3754

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180801003013 MN Practitioner - Optometry 8729336169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
D Stanton Enterprises LLCGroup PAC ID 6608964861, 4 clinicians

Practice addresses (Care Compare)

13900 Northdale Blvd
Rogers, MN 55374-9627
Phone (763) 428-3757

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3569MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
D. Stanton Enterprises, LLC Optometrist CurrentSince Jul 25, 2018 Accepting new patients

Locations

13900 Northdale Blvd
Rogers, MN 55374
Phone (763) 428-3757

1 Central Ave W
Ste 104
Saint Michael, MN 55376
Phone (763) 493-3937

Organizations & group practices 1

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1609360098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13900 NORTHDALE BLVD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553749627",
            "telephone_number": "847-209-3231",
            "fax_number": "763-428-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 NORTHDALE BLVD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "55374",
            "telephone_number": "763-428-3757",
            "fax_number": "763-428-9820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Oakwood Hills",
            "state": "IL",
            "postal_code": "600131130",
            "country_code": "US",
            "telephone_number": "847-209-3231",
            "fax_number": "847-639-6235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Central Ave W Ste 104",
            "address_purpose": "LOCATION",
            "city": "Saint Michael",
            "state": "MN",
            "postal_code": "553764590",
            "country_code": "US",
            "telephone_number": "763-497-3754",
            "fax_number": "763-497-3811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNPHY",
        "first_name": "ERIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, MN

Sources for this page

Verify at the official NPI Registry.