Todd Hamilton Hnatko
Individual provider Active NPI Optometrist · Superior, WI
NPI 1770525347 · NPPES record last updated Apr 29, 2011
Key facts
- NPI
- 1770525347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2877-035 (WI)
- Practice address
- 3500 Tower Ave
Superior, WI 54880-5335 - Phone
- (715) 395-5454
- NPI assigned
- Jun 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 30
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Duluth Clinic LTD
Practice addresses (Care Compare)
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540
502 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364
530 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364
Hospital & facility affiliations
- Essentia Health Duluth
- St Marys Hospital Superior
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060825000041 | WI | Practitioner - Optometry | 4183627557 | Reassigns benefits to 2 organizations |
| I20101208001106 | MN | Practitioner - Optometry | 4183627557 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2877 | WI | MD | Clinical Social Worker |
| 2877-035 | WI | MD | Optometrist |
| 2687 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| St. Mary'S Hospital of Superior | Current |
Accepting new patients | |
| The Duluth Clinic, LTD | Current |
Accepting new patients | |
| St. Mary'S Duluth Clinic Health System | Current | Accepting new patients | |
| St. Mary'S Hospital of Superior | Current | Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Locations
502 E 2nd St
Duluth, MN 55805
Phone (218) 727-8762
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540
3500 Tower Ave
#1
Superior, WI 54880
Phone (715) 395-5457
3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457
3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2877-035 | WI | Yes |
Addresses
Primary practice location
3500 Tower Ave
Superior, WI 54880-5335
Mailing address
3500 Tower Ave
Superior, WI 54880-5335
Phone (715) 395-5454
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38614000 | Medicaid | WI |
Other providers in Superior, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.