NPIMap

Organization Active NPI

DRS. North & Watson, Optometrists P. a.

  • Optometrist
  • Minnetonka, MN
National Provider Identifier
1730119918
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DRS. NORTH & WATSON, OPTOMETRISTS P. A.
Practice address
12511 Wayzata Blvd
Ridgedale Center
Minnetonka, MN 55305-1938
Phone
(952) 591-1970
Fax
(952) 591-1972
NPI assigned
Jul 4, 2006
Last updated
Sep 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Ms. Karin Banerjee
Title
Operations Manager
Phone
(651) 639-0409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

12511 Wayzata Blvd
Ridgedale Center
Minnetonka, MN 55305-1938

Mailing address

12511 Wayzata Blvd
Ridgedale Center
Minnetonka, MN 55305-1938
Phone (952) 591-1970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040908000639 MN Part B Supplier - Clinic/Group Practice 7315913670 Receives reassigned benefits from 6 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burnsville, MN; Minnetonka, MN; Roseville, MN

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
DRS North Watson Optometrists P a3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12511 Wayzata Blvd
Minnetonka, MN 55305
Phone (952) 591-1970

1595 Highway 36 W
Ste 920
Roseville, MN 55113
Phone (651) 639-0407

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1730119918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12511 WAYZATA BLVD",
            "address_2": "RIDGEDALE CENTER",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051938",
            "telephone_number": "952-591-1970",
            "fax_number": "952-591-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 WAYZATA BLVD",
            "address_2": "RIDGEDALE CENTER",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051938",
            "telephone_number": "952-591-1970",
            "fax_number": "952-591-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. NORTH & WATSON, OPTOMETRISTS P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "BANERJEE",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "651-639-0409",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.