North Suburban Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

NORTH SUBURBAN OPTICAL

Doing business as

Optical Studios

Practice address

3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433

Phone

(763) 427-8524

Fax

(763) 527-5141

NPI assigned

Jul 2, 2007

Last updated

Oct 22, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Delta Jorgensen

Title

Organizational Liasion

Phone

(763) 592-8413

Specialties & licenses 1

Addresses

Other names 1

• Optical Studios Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• North Suburban Optical

  dba Optical Studios

  • Eyewear Supplier
  • Blaine, MN
  • NPI 1306042817

  6305181561

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

North Suburban Optical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• North Suburban Optical

  dba Optical Studios

  • Eyewear Supplier
  • Blaine, MN
  • NPI 1306042817
  NPD tax ID

Locations

Practitioners 2

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.

• David V Folden, M.D.

  • Ophthalmology Physician
  • Coon Rapids, MN
  • NPI 1912151929
  NPD (past)
• Mark Lobanoff, M.D.

  • Ophthalmology Physician
  • St Louis Park, MN
  • NPI 1205870045
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1730386723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 COON RAPIDS BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "763-427-8524",
            "fax_number": "763-576-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 COON RAPIDS BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "763-427-8524",
            "fax_number": "763-527-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "JORGENSEN",
        "authorized_official_first_name": "DELTA",
        "authorized_official_title_or_position": "ORGANIZATIONAL LIASION",
        "authorized_official_telephone_number": "763-592-8413"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optical Studios",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Metro Orthotics and Prosthetics, Inc
• North Suburban Chiropractic Clinic P.a.
• North Suburban Counseling Center
• North Suburban Counseling Ctr
• North Suburban Eye Specialists, LLP
• North Suburban Urology of Coon Rapids, Inc.
• Northdale Dentist PA
• Northern OB GYN Associates PC (Northern Ob/Gyn Associates)
• Northern Pines Counseling Center, Inc.
• Northland Dental Partners, PLLC (Cedar Bend Dental Care)

• Eyewear Supplier in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.