Individual provider Active NPI

Shalon Ann Ronning, OD

  • Optometrist
  • Sartell, MN
National Provider Identifier
1770010613
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3504 Issued in MN
Practice address
2180 Troop Dr
Sartell, MN 56377-4563
Phone
(320) 258-3915
Fax
(320) 258-3917
NPI assigned
May 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3504 MN Primary

Addresses

Primary practice location

2180 Troop Dr
Sartell, MN 56377-4563

Mailing address

2180 Troop Dr
Sartell, MN 56377-4563
Phone (320) 258-3915

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sronning@pineconevisioncenter.emadirect.md Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170602001136 MN Practitioner - Optometry 1052688652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinecone Vision Center, PAGroup PAC ID 6800786906, 8 clinicians
MLP OptometryGroup PAC ID 3870820814, 6 clinicians

Practice addresses (Care Compare)

2180 Troop Dr
Sartell, MN 56377-7504
Phone (320) 258-3915

3636 2ND St S
Saint Cloud, MN 56301-3732
Phone (320) 316-9880

Merit-based Incentive Payment System (MIPS)

Final score
64.31 of 100Reported as group
Quality
35
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3504MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MLP Optometry LTD Optometrist CurrentSince Jan 19, 2020 Accepting new patients
Pinecone Vision Center, PA Optometrist CurrentSince Jun 1, 2021 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince May 1, 2020 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince May 1, 2020 Accepting new patients
Pinecone Vision Center, PA Optometrist CurrentSince Jun 1, 2021 Accepting new patients
Midwest Family Eye Center Optometrist Past Accepting new patients

Locations

3636 2nd St S
Saint Cloud, MN 56301
Phone (320) 316-9875

1545 Northway Dr
Ste 120
Saint Cloud, MN 56303
Phone (320) 253-2441

3930 Cedar Grove Pkwy
Saint Paul, MN 55122
Phone (612) 454-5661

2180 Troop Dr
Sartell, MN 56377
Phone (320) 221-0028

206 Division St
Waite Park, MN 56387
Phone (320) 253-0365

Interoperability endpoints

  • Direct secure messaging: sronning@pineconevisioncenter.emadirect.md

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1770010613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 TROOP DR",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774563",
            "telephone_number": "320-258-3915",
            "fax_number": "320-258-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 TROOP DR",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774563",
            "telephone_number": "320-258-3915",
            "fax_number": "320-258-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONNING",
        "first_name": "SHALON",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sronning@pineconevisioncenter.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2180 TROOP DR",
            "city": "SARTELL",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563774563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.