Agassiz Optometry Associates PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2964 Issued in MN

Legal business name

AGASSIZ OPTOMETRY ASSOCIATES PC

Doing business as

Crookston Eye Clinic

Practice address

216 S Main St
Crookston, MN 56716-1939

Phone

(218) 281-2020

NPI assigned

Nov 9, 2011

Last updated

Apr 23, 2014By 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

Dr. Matthew C Forgit, O.D.NPI 1427114214

Title

Optometrist

Phone

(218) 281-2020

Specialties & licenses 1

Addresses

Other names 1

• Crookston Eye Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

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.

• Matthew C Forgit, O.D.

  • Optometrist
  • Crookston, MN
  • NPI 1427114214
  Medicare reassignment Care Compare group NPD Authorized official
• Kynndyl Paige Giannonatti, OD

  • Optometrist
  • Bemidji, MN
  • NPI 1215599980
  Medicare reassignment Care Compare group NPD
• Angela Sue Smith, O.D.

  • Optometrist
  • Crookston, MN
  • NPI 1457569378
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1740567494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 S MAIN ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161939",
            "telephone_number": "218-281-2020",
            "fax_number": "218-281-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S MAIN ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161939",
            "telephone_number": "218-281-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGASSIZ OPTOMETRY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "FORGIT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "218-281-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crookston Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Crookston, MN
• Providers in Crookston, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.