Apolade Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2827 Issued in MN

Legal business name

APOLADE INC

Doing business as

Costco Optical

Practice address

11330 Fountains Dr
Maple Grove, MN 55369-7200

Phone

(763) 494-8063

Fax

(763) 494-8062

NPI assigned

Mar 14, 2007

Last updated

Dec 11, 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

Mr. Tim J Nelson, O.D.

Title

President

Phone

(612) 743-1400

Specialties & licenses 1

Addresses

Other names 1

• Costco Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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.

• Timothy Nelson, OD

  • Optometrist
  • Maple Grove, MN
  • NPI 1215091616
  Medicare reassignment NPD
• Lynette Rose Catapano, OD PC

  • Optometrist
  • Anoka, MN
  • NPI 1861493843
  NPD (past)
• Gregory Donald Jones, O.D.

  • Optometrist
  • Forest Lake, MN
  • NPI 1295829752
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1740313824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N 4TH ST UNIT 704",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011950",
            "telephone_number": "612-743-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 FOUNTAINS DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697200",
            "telephone_number": "763-494-8063",
            "fax_number": "763-494-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLADE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-743-1400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert David Andrews-Mendoza, LADC
• Anesthesia Associates, PLLC
• Angel Wings Transportation
• Kristan Allissa Angerhofer, MS, CCC-SLP
• Angela Antonelli, RN
• Angel David Aponte Tirado, MD
• Hannah Arason
• Arbor Lakes Chiropractic Center P.a.
• Arbor Lakes Senior Living
• Arbor Lakes Senior Living II LLC (Willows of Arbor Lakes)

• Optometrist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.