Jeffrey W Williams, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3461 Issued in MN

Practice address

200 Village Center Dr Ste 300
North Oaks, MN 55127-7088

Phone

(651) 482-1959

Fax

(651) 482-1850

NPI assigned

May 18, 2006

Last updated

Sep 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jeffrey W. Williams, O.D. and Associates, PAGroup PAC ID 6709781180, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeffrey W. Williams, O.D. & Associates, PA

  • Eyewear Supplier
  • New Richmond, WI
  • NPI 1265502272

  MN

  Medicare reassignment Care Compare group Authorized official
• Enhanced Eye Care LLC

  • Optometrist
  • New Richmond, WI
  • NPI 1356171862
  NPD
• Conrad Eye Services, PLC

  • Ophthalmologic Surgery Clinic/Center
  • North Oaks, MN
  • NPI 1649379132
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1750334074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551277088",
            "telephone_number": "651-482-1959",
            "fax_number": "651-482-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR STE 300",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551277088",
            "telephone_number": "651-482-1959",
            "fax_number": "651-482-1850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3480 Bunker Lake Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MN",
            "postal_code": "553042085",
            "country_code": "US",
            "telephone_number": "763-712-9854",
            "fax_number": "763-506-9962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3461",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Vaishnav
• Alexandra Van
• Vop North Oaks, LLC (North Oaks Memory Care)
• Walgreen Co (Walgreens #12403)
• Jo Ann Warren, CD(DONA), M.S.

• Optometrist in North Oaks, MN
• Providers in North Oaks, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.