Individual provider Active NPI

Tracy J. Schauer, O.D.

  • Optometrist
  • Monticello, MN
National Provider Identifier
1790735801
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2928 Issued in MN
Practice address
504 Pine St
Monticello, MN 55362-8570
Phone
(763) 295-0004
Fax
(763) 295-4701
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2928 MN Primary

Addresses

Primary practice location

504 Pine St
Monticello, MN 55362-8570

Mailing address

1421 50TH St NE
Buffalo, MN 55313-3640
Phone (763) 682-4570

Other identifiers 1

IdentifierTypeStateIssuer
271977100MedicaidMN

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
I20040309000137 MN Practitioner - Optometry 3577451897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elaine Happ OD PAGroup PAC ID 3375580426, 5 clinicians

Practice addresses (Care Compare)

560 Cedar St
Monticello, MN 55362-8403
Phone (763) 271-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2928MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elaine Happ OD PA Optometrist CurrentSince Aug 1, 2012 Accepting new patients

Locations

560 Cedar St
Monticello, MN 55362
Phone (763) 270-2020

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1790735801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 50TH ST NE",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553133640",
            "telephone_number": "763-682-4570",
            "fax_number": "763-295-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 PINE ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628570",
            "telephone_number": "763-295-0004",
            "fax_number": "763-295-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAUER",
        "first_name": "TRACY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271977100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

Verify at the official NPI Registry.