Individual provider Active NPI

Amy Renee Schultz, OD

  • Optometrist
  • St Louis Park, MN
National Provider Identifier
1790948859
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3150 Issued in MN
Practice address
3900 Park Nicollet Blvd
St Louis Park, MN 55416-2505
Phone
(952) 993-3150
NPI assigned
Jul 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3150 MN Primary

Addresses

Primary practice location

3900 Park Nicollet Blvd
St Louis Park, MN 55416-2505

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

20094 Kenwood Trl
Lakeville, MN 55044-5404
Phone (952) 469-3937

Other identifiers 6

IdentifierTypeStateIssuer
220005866OtherMNMEDICA
P01484175OtherRAILROAD MEDICARE
HP100317OtherMNHEALTH PARTNERS
0725060001OtherMNDMERC
3150OtherMNSTATE LICENSE
9583251OtherMNAETNA

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
I20090109000248 MN Practitioner - Optometry 5294898797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Point Optical GroupGroup PAC ID 9032491246, 28 clinicians

Practice addresses (Care Compare)

3333 Hazelton Rd
Minneapolis, MN 55435-4204
Phone (952) 926-6149

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3150MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
West Point Optical Group Optometrist CurrentSince Jun 13, 2023 Accepting new patients
Park Nicollet Clinic CurrentSince May 9, 2016 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Park Nicollet Clinic CurrentSince May 9, 2016 Accepting new patients
West Point Optical Group Optometrist Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

3333 Hazelton Rd
Minneapolis, MN 55435
Phone (952) 926-6149

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3900 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-3017

Organizations & group practices 5

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1790948859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162505",
            "telephone_number": "952-993-3150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20094 Kenwood Trl",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "550445404",
            "country_code": "US",
            "telephone_number": "952-469-3937",
            "fax_number": "952-469-2132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "AMY",
        "middle_name": "RENEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "220005866",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01484175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP100317",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0725060001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3150",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9583251",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.