Individual provider Active NPI

Aleisha Joo Nordin, O.D.

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1770546806
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2924 Issued in MN
Practice address
256 Johnson Pkwy
Saint Paul, MN 55106-6410
Phone
(651) 226-7407
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2924 MN Primary

Addresses

Primary practice location

256 Johnson Pkwy
Saint Paul, MN 55106-6410

Mailing address

256 Johnson Pkwy
Saint Paul, MN 55106-6410
Phone (651) 226-7407

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
I20040913000570 MN Practitioner - Optometry 6901873769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Eye Care PAGroup PAC ID 5991734691, 2 clinicians

Practice addresses (Care Compare)

4175 Vinewood LN N
Plymouth, MN 55442-2624
Phone (763) 551-3681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2924MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Eye Care PA Optometrist CurrentSince Mar 9, 2020 Accepting new patients

Locations

3035 Denmark Ave
Eagan, MN 55121
Phone (651) 405-0942

4175 Vinewood Ln N
Plymouth, MN 55442
Phone (763) 381-4461

Organizations & group practices 1

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1770546806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 JOHNSON PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066410",
            "telephone_number": "651-226-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 JOHNSON PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066410",
            "telephone_number": "651-226-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDIN",
        "first_name": "ALEISHA",
        "middle_name": "JOO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.