Organization Active NPI

Vantage Point Eyes PLLC

  • Optometrist
  • Woodbury, MN
National Provider Identifier
1649864919
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VANTAGE POINT EYES PLLC
Practice address
755 Bielenberg Dr Ste 103
Woodbury, MN 55125-4443
Phone
(651) 504-5901
Fax
(651) 504-5902
NPI assigned
Feb 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Dr. Lisa Jo Holtman, ODNPI 1710407622
Title
Optometrist/Owner
Phone
(651) 504-5901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

755 Bielenberg Dr Ste 103
Woodbury, MN 55125-4443

Mailing address

755 Bielenberg Dr Ste 103
Woodbury, MN 55125-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210325000413 MN Part B Supplier - Clinic/Group Practice 6507273216 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, MN

National Provider Directory

National Provider Directory

Locations

755 Bielenberg Dr
Ste 103
Woodbury, MN 55125
Phone (651) 504-5901

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1649864919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 BIELENBERG DR STE 103",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 BIELENBERG DR STE 103",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254443",
            "telephone_number": "651-504-5901",
            "fax_number": "651-504-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE POINT EYES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "HOLTMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "651-504-5901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.