Individual provider Active NPI

Kayleen Dempsey

  • Optometrist
  • Sauk Rapids, MN
National Provider Identifier
1639622376
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3523 Issued in MN
Practice address
1311 2ND St N Ste 105
Sauk Rapids, MN 56379-2582
Phone
(320) 774-3666
Fax
(320) 774-3660
NPI assigned
Jul 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002505 VA
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3523 MN Primary

Addresses

Primary practice location

1311 2ND St N Ste 105
Sauk Rapids, MN 56379-2582

Mailing address

4796 Patterson Mill Road
Bedford, VA 24523

Other practice location 1

2413 Wards Road
Lynchburg, VA 24502
Phone (434) 239-5323

Other practice location 2

4801 Veterans Dr
Saint Cloud, MN 56303-2015
Phone (320) 255-6480 ext. 5432

Other practice location 3

4142 W Division St
Saint Cloud, MN 56301-3706
Phone (320) 252-2500

Other practice location 4

219 14th St S
Benson, MN 56215-1775
Phone (320) 774-3666

Other practice location 5

20 9th St SE
Long Prairie, MN 56347-1404
Phone (320) 774-3666

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
I20190612001160 MN Practitioner - Optometry 4385922343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dvorak Cataract and Eye Laser Clinic, PA 3 clinicians

Practice addresses (Care Compare)

1311 2ND St N
Suite 105
Sauk Rapids, MN 56379-2582
Phone (320) 774-3666

Merit-based Incentive Payment System (MIPS)

Final score
73.82 of 100Reported as group
Quality
88.41
Promoting interoperability
100
Improvement activities
40
Cost
24.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002505VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dvorak Cataract and Eye Laser Clinic, PA Single Specialty CurrentSince Aug 6, 2019 Accepting new patients
America'S Best Contacts and Eyeglasses, Inc. Past Accepting new patients

Locations

219 14th St S
Benson, MN 56215
Phone (320) 774-3666

20 9th St SE
Long Prairie, MN 56347
Phone (320) 732-2131

1311 2nd St N
Ste 105
Sauk Rapids, MN 56379
Phone (320) 774-3666

1311 2nd St N
Sauk Rapids, MN 56379

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": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1639622376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4796 PATTERSON MILL ROAD",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "24523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 2ND ST N STE 105",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563792582",
            "telephone_number": "320-774-3666",
            "fax_number": "320-774-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2413 Wards Road",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "24502",
            "country_code": "US",
            "telephone_number": "434-239-5323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4801 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563032015",
            "country_code": "US",
            "telephone_number": "320-255-6480 x5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4142 W Division St",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563013706",
            "country_code": "US",
            "telephone_number": "320-252-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "219 14th St S",
            "address_purpose": "LOCATION",
            "city": "Benson",
            "state": "MN",
            "postal_code": "562151775",
            "country_code": "US",
            "telephone_number": "320-774-3666",
            "fax_number": "320-774-3660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 9th St SE",
            "address_purpose": "LOCATION",
            "city": "Long Prairie",
            "state": "MN",
            "postal_code": "563471404",
            "country_code": "US",
            "telephone_number": "320-774-3666",
            "fax_number": "320-774-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMPSEY",
        "first_name": "KAYLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002505",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Rapids, MN

Sources for this page

Verify at the official NPI Registry.