Kaitlyn Huebsch Hollenbach, OD, FAAO

Primary specialty

OptometristTaxonomy code 152W00000X

License

3650 Issued in MN

Practice address

409 Dunlap St N
Saint Paul, MN 55104-4201

Phone

(651) 290-9200

Fax

(651) 290-9211

NPI assigned

Aug 21, 2018

Last updated

Feb 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

New England College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Cities Health Center IncGroup PAC ID 5799696621, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDHIBD

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.

• Open Cities Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1225101405
  Medicare reassignment Care Compare group NPD
• Open Cities Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1538037619
  NPD
• Optometric Services, LLC

  • Optometrist
  • Roseville, MN
  • NPI 1518010495
  NPD (past)

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1689154429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 HENNEPIN AVE S APT 329",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012478",
            "telephone_number": "319-551-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 DUNLAP ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200",
            "fax_number": "651-290-9211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2716 Lincoln Dr",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551131333",
            "country_code": "US",
            "telephone_number": "651-631-9394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLENBACH",
        "first_name": "KAITLYN",
        "middle_name": "HUEBSCH",
        "name_prefix": "Dr.",
        "credential": "OD, FAAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel S Holger, MD
• Holistic Behavioral Health LLC
• Holistic Nursing Corp
• Deidra S Holland, MSOT, ED.D.
• Sharon Joanne Holle, LADC
• Nora Lyn Hollenkamp, LICSW
• Krystle Holliday
• Ronda Holliday
• Jane Mary Hollis, M.A., L..P.
• Howard Hollischer, PTA

• Optometrist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.