Individual provider Active NPI

Toni Lynn Watt, O.D.

  • Optometrist
  • Albert Lea, MN
National Provider Identifier
1629398516
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3207 Issued in MN
Practice address
2610 Bridge Ave
Albert Lea, MN 56007-2075
Phone
(507) 373-2269
NPI assigned
Jun 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3207 MN Primary

Addresses

Primary practice location

2610 Bridge Ave
Albert Lea, MN 56007-2075

Mailing address

2610 Bridge Ave
Albert Lea, MN 56007-2075
Phone (503) 701-8323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20160801001945 ID Practitioner - Optometry 4183803851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Eyecare PLLCGroup PAC ID 4284867888, 8 clinicians

Practice addresses (Care Compare)

1689 Pancheri Dr
Idaho Falls, ID 83402-3169
Phone (208) 529-4333

3351 Merlin Dr
Idaho Falls, ID 83404-7405
Phone (208) 522-5594

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Eyecare PLLC Optometrist CurrentSince Jul 5, 2016 Accepting new patients
Westside Eyecare Inc Optometrist PastSince Nov 17, 2008 Accepting new patients

Locations

3351 Merlin Dr
Idaho Falls, ID 83404
Phone (208) 522-5594

1689 Pancheri Dr
Idaho Falls, ID 83402
Phone (208) 529-4333

353 N 4th Ave
Ste 110
Pocatello, ID 83201
Phone (208) 233-7832

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.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1629398516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 BRIDGE AVE",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072075",
            "telephone_number": "503-701-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 BRIDGE AVE",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072075",
            "telephone_number": "507-373-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "TONI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.