Shari Marie Anderson, OD
Individual provider Active NPI Optometrist · Roseville, MN
NPI 1639699846 · NPPES record last updated Jul 30, 2019
Key facts
- NPI
- 1639699846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3505 (MN)
- Practice address
- 2480 Fairview Ave N
Roseville, MN 55113-2699 - Phone
- (651) 639-0407
- NPI assigned
- Jun 20, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Advanced Eyecare Apple Valley Inc
DRS. North and Watson, Optometrists P. a.
Practice addresses (Care Compare)
15160 Foliage Ave
Suite 180
Saint Paul, MN 55124-5916
Phone (952) 953-4141
2070 Burnsville Ctr
Suite 72
Burnsville, MN 55306-4416
Phone (952) 435-3686
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170913002857 | MN | Practitioner - Optometry | 6608149661 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3505 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. North & Watson, Optometrists P. a. | Optometrist | Current | Accepting new patients |
| DRS. North & Watson, Optometrists P. a. | Optometrist | Current |
Accepting new patients |
| Advanced Eyecare Apple Valley Inc. | Optometrist | Current |
Accepting new patients |
| DRS. North & Watson, Optometrists P. a. | Optometrist | Past | Accepting new patients |
| DRS. North & Watson, Optometrists P. a. | Optometrist | Past | Accepting new patients |
| Luxottica of America Inc | Past | Accepting new patients |
Locations
2070 Burnsville Ctr
#72
Burnsville, MN 55306
Phone (952) 435-3686
304 N Garden
Minneapolis, MN 55425
Phone (952) 858-8410
12513 Wayzata Blvd
Minnetonka, MN 55305
Phone (952) 591-1966
1595 Highway 36 W
Ste 920
Roseville, MN 55113
Phone (651) 639-0407
2480 Fairview Ave N
Saint Paul, MN 55113
Phone (651) 639-0407
15160 Foliage Ave
Ste 180
Saint Paul, MN 55124
Phone (952) 953-4141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3505 | MN | Yes |
Addresses
Primary practice location
2480 Fairview Ave N
Roseville, MN 55113-2699
Mailing address
15160 Foliage Ave # 180
Apple Valley, MN 55124-5916
Phone (952) 953-4151
Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.