NPIMap

Organization Active NPI

Molacek Family Eyecare, Inc.

  • Optometrist
  • Milaca, MN
National Provider Identifier
1609869031
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MOLACEK FAMILY EYECARE, INC.
Practice address
132 2ND Ave SW
Milaca, MN 56353-1106
Phone
(320) 983-3434
Fax
(320) 983-6280
NPI assigned
Aug 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Dr. Kimberly Ann Molacek, ODNPI 1811914351
Title
Owner
Phone
(320) 983-3434

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

132 2ND Ave SW
Milaca, MN 56353-1106

Mailing address

PO Box 218
Milaca, MN 56353-0218
Phone (320) 983-3434

Other identifiers 1

IdentifierTypeStateIssuer
160138500MedicaidMN

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040928001052 MN Part B Supplier - Clinic/Group Practice 1850360603 Receives reassigned benefits from 2 practitioners
Practice locations: Foley, MN; Milaca, MN
O20100930088319 MN DME Supplier - Physician - OptometristDME Supplier - Optician 1850360603 Practice locations: Milaca, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Molacek Family Eyecare Inc132 2ND Ave SW, Milaca, MN 56353-1106(320) 983-3434 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2003

National Provider Directory

National Provider Directory

Locations

132 2nd Ave SW
Milaca, MN 56353
Phone (320) 983-3434

Practitioners & affiliated clinicians

Practitioners 3

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": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1609869031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "MILACA",
            "state": "MN",
            "postal_code": "563530218",
            "telephone_number": "320-983-3434",
            "fax_number": "320-983-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 2ND AVE SW",
            "city": "MILACA",
            "state": "MN",
            "postal_code": "563531106",
            "telephone_number": "320-983-3434",
            "fax_number": "320-983-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLACEK FAMILY EYECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "MOLACEK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-983-3434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160138500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milaca, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.