Individual provider Active NPI

Abby Bunnell, OD

  • Optometrist
  • Bloomington, MN
National Provider Identifier
1629701099
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3804 Issued in MN
Practice address
9117 Lyndale Ave S
Bloomington, MN 55420-3522
Phone
(952) 230-6200
NPI assigned
Jul 5, 2022
Last updated
Jul 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3804 MN Primary

Addresses

Primary practice location

9117 Lyndale Ave S
Bloomington, MN 55420-3522

Mailing address

9117 Lyndale Ave S
Bloomington, MN 55420-3522

Other identifiers 1

IdentifierTypeStateIssuer
3804MedicaidMN

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
I20220826002198 MN Practitioner - Optometry 0648654509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chu Laser Eye Institute, PAGroup PAC ID 4082644786, 6 clinicians

Practice addresses (Care Compare)

9117 Lyndale Ave S
Bloomington, MN 55420-3522
Phone (952) 835-1235

Merit-based Incentive Payment System (MIPS)

Final score
92.88 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3804MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chu Laser Eye Institute, PA CurrentSince Jul 1, 2022 Accepting new patients

Locations

9117 Lyndale Ave S
Minneapolis, MN 55420
Phone (952) 835-1235

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, 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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1629701099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9117 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9117 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203522",
            "telephone_number": "952-230-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNELL",
        "first_name": "ABBY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3804",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.