Jeffrey Paul Sanderson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

44481 Issued in MN

Practice address

5137 Gus Young Lane
Sanderson Eye Specialists
Edina, MN 55436

Phone

(952) 641-6226

Fax

(952) 641-6229

NPI assigned

Aug 22, 2005

Last updated

Jul 31, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Sanderson Eye PLLC

  • Ophthalmology Physician
  • Edina, MN
  • NPI 1457584336
  Authorized official Same address or phone
• Fairview Clinics

  dba Fairview Clinics - Integrated Primary Care

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1043516867
  NPD
• Fairview Express Care

  dba University of Minnesota Physicians Heart at Fairview

  • Cardiovascular Disease Physician
  • Edina, MN
  • NPI 1710133343
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD
• Cornea and Contact Lens Institute of Minnesota

  • Optometrist
  • Edina, MN
  • NPI 1265733471

  Ophthalmology

  NPD (past)
• Don Sealock, O.D., P.a.

  dba Four Seasons Eyecare

  • Optometrist
  • Plymouth, MN
  • NPI 1497785620
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1669464970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5137 GUS YOUNG LANE",
            "address_2": "SANDERSON EYE SPECIALISTS",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55436",
            "telephone_number": "952-641-6226",
            "fax_number": "952-641-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5137 GUS YOUNG LANE",
            "address_2": "SANDERSON EYE SPECIALISTS",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55436",
            "telephone_number": "952-641-6226",
            "fax_number": "952-641-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "200513762",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "44481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanctum Psychotherapy
• Kendall Sandberg
• Allison Wayva Sanders
• Elise M Sanders, L.I.C.S.W.
• Sanderson Eye PLLC
• Scott Ehren Sanderson, M.D.
• Rachel Lynn Sang, MD
• Farhad William Sani, M.D.
• Maisy Monica Sanneman, PA-C
• Prachi Sansare

• Ophthalmology Physician in Edina, MN
• Providers in Edina, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.