Active NPI
Trevor Mox, OD
- Optometrist
- Roseville, MN
National Provider Identifier
1619031002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3041
- Practice address
- 503 Rosedale Shopping Ctr
Roseville, MN 55113-3004 - Phone
- (651) 631-8900
- Fax
- (651) 631-1003
- NPI assigned
- Dec 20, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3041 | MN | Primary |
Addresses
Primary practice location
503 Rosedale Shopping Ctr
Roseville, MN 55113-3004
Mailing address
11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6663
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2033 Maplewood Mall
Maplewood, MN 55109-1228
Phone (651) 777-0330
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision World Inc | Past | Accepting new patients | |
| Vision World Inc | Past | Accepting new patients |
Organizations & group practices 3
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": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1619031002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11103 WEST AVE",
"address_2": "SUITE 6",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782131370",
"telephone_number": "210-524-6663",
"fax_number": "210-524-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 ROSEDALE SHOPPING CTR",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551133004",
"telephone_number": "651-631-8900",
"fax_number": "651-631-1003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOX",
"first_name": "TREVOR",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.