Individual provider Active NPI

Cassie Mairs Knipple, OD

  • Optometrist
  • Crosby, MN
National Provider Identifier
1710214432
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3190 Issued in MN
Practice address
1 3Rd Ave NE
Crosby, MN 56441-1665
Phone
(800) 952-3766
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3338ATI OR
Optometrist 152W00000X 3190 MN Primary

Addresses

Primary practice location

1 3Rd Ave NE
Crosby, MN 56441-1665

Mailing address

1 3Rd Ave NE
Crosby, MN 56441-1665

Other names 1

  • Cassie Mairs Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100812001029 MN Practitioner - Optometry 3870627813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S Sjoberg PLCGroup PAC ID 0244459824, 7 clinicians

Practice addresses (Care Compare)

7636 Design Rd
Suite 105
Baxter, MN 56425-8678
Phone (218) 825-1976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3190MNMDOptometrist
3338ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
S Sjoberg PLC Optometrist CurrentSince Sep 19, 2014 Accepting new patients
S Sjoberg PLC Optometrist CurrentSince Sep 19, 2014 Accepting new patients

Locations

200 Bunker Hill Dr
Aitkin, MN 56431
Phone (218) 927-2121

7636 Design Rd
Ste 105
Baxter, MN 56425
Phone (218) 546-5708

1 3rd Ave NE
Crosby, MN 56441
Phone (218) 546-5108

Interoperability endpoints

  • Direct secure messaging: cassie.mairs.p1@direct.greatrivereyeclinic.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1710214432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 3RD AVE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 3RD AVE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411665",
            "telephone_number": "800-952-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIRS KNIPPLE",
        "first_name": "CASSIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3338ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIE",
            "last_name": "MAIRS",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Crosby, MN

Sources for this page

Verify at the official NPI Registry.