Individual provider Active NPI

Brian J Snyder, O.D.

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1609871557
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2880 Issued in MN
Practice address
757 Cleveland Ave S
Saint Paul, MN 55116-1302
Phone
(651) 699-5400
Fax
(651) 789-3155
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2880 MN Primary

Addresses

Primary practice location

757 Cleveland Ave S
Saint Paul, MN 55116-1302

Mailing address

1887 Montreal Ave
Saint Paul, MN 55116-2036
Phone (612) 619-6038

Other identifiers 1

IdentifierTypeStateIssuer
132539600MedicaidMN

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
I20060519000108 MN Practitioner - Optometry 8628976693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

757 Cleveland Ave S
Saint Paul, ME 55116-1302

757 Cleveland S Ave
Saint Paul, MN 55116-1302
Phone (651) 699-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Snyder Vision Optometrists PLLC Optometrist CurrentSince Jan 27, 2010 Accepting new patients

Locations

757 Cleveland Ave S
Saint Paul, MN 55116
Phone (651) 699-1547

490 Snelling Ave S
Saint Paul, MN 55116
Phone (651) 255-9999

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1609871557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 MONTREAL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162036",
            "telephone_number": "612-619-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 CLEVELAND AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161302",
            "telephone_number": "651-699-5400",
            "fax_number": "651-789-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132539600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.