Nathan Haverkamp, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3576 Issued in MN

Practice address

3001 White Bear Ave N Ste 150
Maplewood, MN 55109-1215

Phone

(651) 770-3923

NPI assigned

Jun 27, 2018

Sex

Male

Sole proprietor

Yes

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grace Vision IncGroup PAC ID 8022247998, 4 clinicians

Practice addresses (Care Compare)

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.

• Grace Vision, Inc.

  • Optician
  • Saint Paul, MN
  • NPI 1386077592

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1669967188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18715 WILLOW SPRINGS RD",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565017997",
            "telephone_number": "218-849-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WHITE BEAR AVE N STE 150",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091215",
            "telephone_number": "651-770-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERKAMP",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duane K Hasegawa, MD
• Sumayo A Hassan
• Donald Steven Hathaway, LADC
• Thomas Martin Hauth, M.D.
• Renee Irene Hauwiller, MSW, LICSW
• Kari Hawkinson
• Erika Enriquez Haycraft, M.D.T.
• Healtheast Care System
• Healtheast Medical Research Institute
• Healtheast Medical Research Institute

• Optometrist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.