Tanya S Erntson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2927 Issued in MN

Practice address

4455 Highway 169 N
Plymouth, MN 55442-2897

Phone

(763) 559-7358

Fax

(763) 559-2167

NPI assigned

Jan 5, 2006

Last updated

Nov 17, 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

Other identifiers 1

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

Pacific University - College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elk River Eye Clinic, P.a.Group PAC ID 8729011093, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Elk River Eye Clinic, P.a.

  • Optometrist
  • Elk River, MN
  • NPI 1063457943
  Medicare reassignment Care Compare group NPD
• The Total Vision Institute LLC

  • Ophthalmologic Surgery Clinic/Center
  • St Louis Park, MN
  • NPI 1043760119
  NPD
• Don Sealock, O.D., P.a.

  dba Four Seasons Eyecare - Maple Grove

  • Eyewear Supplier
  • Maple Grove, MN
  • NPI 1538624341
  NPD (past)
• Hometown Eye Care, Inc

  • Optometrist
  • Big Lake, MN
  • NPI 1841221785
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1700864279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 HIGHWAY 169 N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422897",
            "telephone_number": "763-559-7358",
            "fax_number": "763-559-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 HIGHWAY 169 N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422897",
            "telephone_number": "763-559-7358",
            "fax_number": "763-559-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNTSON",
        "first_name": "TANYA",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "717678300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kai Song Erickson
• Lauren Erickson, LGSW
• Alyssa Ann Erlandson, MOT, OTR/L
• Eric William Ernest, MS
• Julie K Ernest, CCC-SLP
• Brandy Espy
• Thomas Esser, D.O.
• Wanda J Ethen, MD
• Jocelyn Marijke Etten, CRNA
• Evan Hall Joseph Evan Hall, LADC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.