Trent N. Thielke, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3183 Issued in MN

Practice address

2080 Woodwinds Dr Ste 110
Woodbury, MN 55125-2524

Phone

(651) 738-6800

NPI assigned

Dec 22, 2008

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

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 1

Specialty

Optometry

Education

Southern College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Paul Eye Clinic PA 20 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.92 of 100Reported as group

Quality

89.37

Promoting interoperability

100

Improvement activities

40

Cost

73.71

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 and National Provider Directory roles.

• St Paul Eye Clinic PA

  • Ophthalmologic Surgery Clinic/Center
  • Woodbury, MN
  • NPI 1720173651

  MN

  Medicare reassignment Care Compare group NPD
• St Paul Eye Clinic PA

  • Eyewear Supplier
  • Woodbury, MN
  • NPI 1669574646
  NPD

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1760628788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR STE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252524",
            "telephone_number": "651-738-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR STE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252524",
            "telephone_number": "651-738-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELKE",
        "first_name": "TRENT",
        "middle_name": "N.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-22",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3145-035",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Breyonna Thomas, MOT, OTR/L
• Lisa Marie Thomas, LICSW

• All providers in Woodbury, MN
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.