Individual provider Active NPI

Rodney Jerome Hess, OD

  • Optometrist
  • Elk River, MN
National Provider Identifier
1730113887
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2535 Issued in MN
Practice address
19022 Freeport Ave NW
Elk River, MN 55330-4767
Phone
(763) 441-1055
Fax
(763) 441-7024
NPI assigned
Jul 11, 2006
Last updated
May 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2535 MN Primary
Corneal and Contact Management Optometrist 152WC0802X 2535 MN
Pediatric Optometrist 152WP0200X 2535 MN
Occupational Vision Optometrist 152WX0102X 2535 MN

Addresses

Primary practice location

19022 Freeport Ave NW
Elk River, MN 55330-4767

Mailing address

19022 Freeport Ave NW
Suite H
Elk River, MN 55330-4767
Phone (763) 441-1055

Other identifiers 7

IdentifierTypeStateIssuer
410047336OtherMNRAILROAD MEDICARE
HP18116OtherMNHEALTH PARTNERS
1009722OtherMNPREFERRED ONE
22-01028OtherMNMEDICA
4C529HEOtherMNBLUE CROSS BLUE SHIELD
858814700MedicaidMN
115817OtherMNUCARE

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
I20050916000276 MN Practitioner - Optometry 8628001997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
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)

19022 Freeport Ave NW H
Elk River, MN 55330-4767
Phone (763) 441-1055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elk River Eye Clinic, P.a. Optometrist CurrentSince Jan 1, 2002 Accepting new patients

Locations

19022 Freeport St NW
Ste H
Elk River, MN 55330
Phone (763) 441-1055

822 Main St NW
Elk River, MN 55330
Phone (763) 441-1055

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1730113887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19022 FREEPORT AVE NW",
            "address_2": "SUITE H",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304767",
            "telephone_number": "763-441-1055",
            "fax_number": "763-441-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19022 FREEPORT AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304767",
            "telephone_number": "763-441-1055",
            "fax_number": "763-441-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESS",
        "first_name": "RODNEY",
        "middle_name": "JEROME",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2535",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "2535",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MN",
            "license": "2535",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "MN",
            "license": "2535",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410047336",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP18116",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1009722",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-01028",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4C529HE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "858814700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "115817",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.