Matthew Hennen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3467 Issued in MN

Practice address

1540 Humboldt Ave
Suite 201
West St Paul, MN 55118-3417

Phone

(651) 457-2020

NPI assigned

May 31, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dakota Optometric Eye Care Associates, P.a.Group PAC ID 0749381218, 5 clinicians

MJH LLCGroup PAC ID 9032472139, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dakota Optometric Eye Care Associates, P.a.

  • Optometrist
  • Saint Paul, MN
  • NPI 1598773780
  Medicare reassignment Care Compare group NPD
• MJH LLC

  • Optometrist
  • Stillwater, MN
  • NPI 1558723411
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1639527708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 HUMBOLDT AVE",
            "address_2": "SUITE 201",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183417",
            "telephone_number": "651-457-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 HUMBOLDT AVE",
            "address_2": "SUITE 201",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183417",
            "telephone_number": "651-457-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEN",
        "first_name": "MATTHEW",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Travis Hansen, PHARMD
• Ashley Hanson-Oni
• Lindsay Harmon
• Nicole Michelle Helland, LICSW
• Elizabeth Ann Hendrikson, LICSW
• Allyssa Ann Herning, CMT
• Hodan Home Care LLC
• Lisa Hoffman-Konn, PHD
• Rachel Anne Hogan, LICSW
• Holistic Mental Health PLLC

• Optometrist in West St Paul, MN
• Providers in West St Paul, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.

Verify at the official NPI Registry.