James Stanley Anderson, OD

Individual provider Active NPI Optometrist · Eden Prairie, MN

NPI 1619964459 · NPPES record last updated Jul 1, 2024

Key facts

NPI
1619964459
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
1637 (MN)
Practice address
16550 W 78TH St
Suite a
Eden Prairie, MN 55346-4315
Phone
(952) 934-6926
Fax
(952) 934-3402
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Pacific University - College of Optometry, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Clinic and Contact Lens Center (3 clinicians)

Practice addresses (Care Compare)

1160 Wayzata Blvd E
Wayzata, MN 55391-1963
Phone (952) 473-7505

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100316000584 MN Practitioner - Optometry 0446269286 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Clinic & Contact Lens Center Optometrist Current
since May 20, 2024
Accepting new patients
Family Eye Clinic & Contact Lens Center Optometrist Current Accepting new patients

Locations

3822 W Old Shakopee Rd
Bloomington, MN 55431
Phone (952) 884-4366

16550 W 78th St
Eden Prairie, MN 55346

16550 W 78th St
Ste A
Eden Prairie, MN 55346
Phone (952) 934-6926

1160 Wayzata Blvd E
Wayzata, MN 55391
Phone (952) 473-7505

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1637 MN Yes

Addresses

Primary practice location

16550 W 78TH St
Suite a
Eden Prairie, MN 55346-4315

Mailing address

16550 W 78TH St
Suite a
Eden Prairie, MN 55346-4315
Phone (952) 934-6926

Other providers in Eden Prairie, MN

All providers in Eden Prairie, MN · Optometrist in Minnesota

Sources for this page

Verify at the official NPI Registry.