Individual provider Active NPI

Benet Michael Friederichs, OD

  • Optometrist
  • Buffalo, MN
National Provider Identifier
1720820624
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3935 Issued in MN
Practice address
103 Center Dr Ste 100
Buffalo, MN 55313-2958
Phone
(763) 682-1282
NPI assigned
Jun 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3935 MN Primary

Addresses

Primary practice location

103 Center Dr Ste 100
Buffalo, MN 55313-2958

Mailing address

16097 Lake Koronis Rd
Paynesville, MN 56362-9333
Phone (320) 293-2538

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
I20241016002898 MN Practitioner - Optometry 5799223301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagan Eye Clinic LLCGroup PAC ID 0345220745, 48 clinicians

Practice addresses (Care Compare)

103 Ctr Dr
Suite 100
Buffalo, MN 55313-2958
Phone (763) 682-1282

204 Washburne Ave
Paynesville, MN 56362-1643
Phone (320) 204-6400

3930 Cedar Grove Pkwy
Eagan, MN 55122-1403
Phone (651) 454-5661

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Eye Clinic LLC Optometrist CurrentSince Aug 8, 2024 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince Aug 8, 2024 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

103 Center Dr
Ste 100
Buffalo, MN 55313
Phone (763) 682-1282

103 Center Dr
Buffalo, MN 55313
Phone (763) 684-3807

3930 Cedar Grove Pkwy
Saint Paul, MN 55122
Phone (612) 454-5661

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": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1720820624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16097 LAKE KORONIS RD",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563629333",
            "telephone_number": "320-293-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CENTER DR STE 100",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132958",
            "telephone_number": "763-682-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDERICHS",
        "first_name": "BENET",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.