Eye Associates of Central Minnesota PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EYE ASSOCIATES OF CENTRAL MINNESOTA PA

Practice address

628 Roosevelt Rd
Suite 101
Saint Cloud, MN 56301-4867

Phone

(320) 774-3789

Fax

(320) 774-3483

NPI assigned

Dec 1, 2016

Organization subpart

No

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

Authorized official

Name

Julie Olmscheid

Title

Office Manager

Phone

(320) 774-3789

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mitchell Vincent Gossman, MD

  • Ophthalmology Physician
  • Saint Cloud, MN
  • NPI 1447298443
  Medicare reassignment Care Compare group NPD
• Melanie Jo Lirong Thares, OD

  • Optometrist
  • Saint Cloud, MN
  • NPI 1518601442
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1790228294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 ROOSEVELT RD",
            "address_2": "SUITE 101",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014867",
            "telephone_number": "320-774-3789",
            "fax_number": "320-774-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 ROOSEVELT RD",
            "address_2": "SUITE 101",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014867",
            "telephone_number": "320-774-3789",
            "fax_number": "320-774-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF CENTRAL MINNESOTA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-01",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "OLMSCHEID",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "320-774-3789"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Weir Ewing, M.D.
• Kristin N.M. Ewing, RDLD
• Michael J.M. Ewing
• Excellent Car Seat LLC
• Excellent Services LLC
• Eye Kraft Optical, Inc
• Eye Surgeons & Physicians PA
• Eye Surgeons & Physicians PA
• Sara Elizabeth Faber, PHARMD
• Richard Michael Fagerness, RPH

• Ophthalmology Physician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.