NPIMap

Organization Active NPI

Minnesota Eyecare Network, Inc.

  • Eyewear Supplier
  • Pelican Rapids, MN
National Provider Identifier
1770701047
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
MINNESOTA EYECARE NETWORK, INC.
Practice address
20 South Broadway
Pelican Rapids, MN 56572
Phone
(218) 863-7061
Fax
(218) 863-7062
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Timothy C Neitzke, OD
Title
President
Phone
(218) 346-3310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X MN Primary

Addresses

Primary practice location

20 South Broadway
Pelican Rapids, MN 56572

Mailing address

20 South Broadway
PO Box 474
Pelican Rapids, MN 56572
Phone (218) 863-7061

Other names 1

  • Pelican Rapids Eye Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Azure Vision Care20 S Broadway, Pelican Rapids, MN 56572-0474(218) 863-7061 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1996

National Provider Directory

National Provider Directory
Tax ID family
Minnesota Eyecare Netwo6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1770701047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SOUTH BROADWAY",
            "address_2": "PO BOX 474",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "56572",
            "telephone_number": "218-863-7061",
            "fax_number": "218-863-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SOUTH BROADWAY",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "56572",
            "telephone_number": "218-863-7061",
            "fax_number": "218-863-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA EYECARE NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NEITZKE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-346-3310",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pelican Rapids Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pelican Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.