Staples Eye Clinic PSC

Primary specialty

OptometristTaxonomy code 152W00000X

License

3172 Issued in MN

Legal business name

STAPLES EYE CLINIC PSC

Practice address

922 US 10 East
Staples, MN 56479

Phone

(218) 894-1331

Fax

(218) 895-1332

NPI assigned

Dec 8, 2011

Last updated

May 8, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Seth Alan DokkenNPI 1679734636

Title

President

Phone

(218) 894-1331

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

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

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Seth Alan Dokken, O.D.

  • Optometrist
  • Staples, MN
  • NPI 1679734636
  Medicare reassignment Care Compare group NPD Authorized official
• Jesse Fenstermacher, OD

  • Optometrist
  • Staples, MN
  • NPI 1194339481
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557273600000",
    "number": "1821366683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 US 10 EAST",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564792428",
            "telephone_number": "218-894-1331",
            "fax_number": "218-895-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 US 10 EAST",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "56479",
            "telephone_number": "218-894-1331",
            "fax_number": "218-895-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAPLES EYE CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2019-05-08",
        "status": "A",
        "authorized_official_last_name": "DOKKEN",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-894-1331",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2334531",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Mary Smeby, NP
• Spandl Chiropractic P.C.
• Brockston Anthony Spandl, D.C.
• St Joseph's Medical Center (Essentia Health St Josephs Staples Clinic)
• St. Cloud Hospital (CentraCare Kidney Program - Staples Dialysis)
• Staples Smiles
• Wade T Swenson II, MD
• Kelly Rose Taffe, SLP
• Debra Tastad, RN,CNS
• Jon Frederic Theurer, DC

• Optometrist in Staples, MN
• Providers in Staples, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.