Apolade Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2827 Issued in MN

Legal business name

APOLADE INC

Practice address

11330 Fountains Dr
Maple Grove, MN 55369-7200

Phone

(763) 494-8063

Fax

(763) 494-8062

NPI assigned

Mar 14, 2007

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.

• 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

• 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.