Individual provider Active NPI

Meredith Stallone

  • Optometrist
  • Maple Grove, MN
National Provider Identifier
1821589680
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008777 Issued in NY
Practice address
14500 99TH Ave N Ste 100
Maple Grove, MN 55369-4738
Phone
(763) 898-1000
NPI assigned
May 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008777 NY Primary

Addresses

Primary practice location

14500 99TH Ave N Ste 100
Maple Grove, MN 55369-4738

Mailing address

57 Benson Ave
Sayville, NY 11782-2916

Other practice location 1

33 W 42nd St
New York, NY 10036
Phone (212) 938-4000

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
I20191202000399 MN Practitioner - Optometry 4688923717 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008777NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Dec 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 2, 2020 Accepting new patients
Fairview Clinics CurrentSince Dec 29, 2020 Accepting new patients
Fairview Clinics CurrentSince Dec 29, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 2, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 2, 2020 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Visionary Eye Care, PA Optometrist CurrentSince Jul 27, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 2, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 2, 2020 Accepting new patients
Fairview Health Services CurrentSince Dec 1, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jan 2, 2020 Accepting new patients

Locations

303 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 460-4000

851 W 78th St
Chanhassen, MN 55317
Phone (952) 252-1208

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

18275 Kenrick Ave
Lakeville, MN 55044
Phone (952) 892-0028

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

7000 York Ave S
Minneapolis, MN 55435
Phone (952) 922-8118

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

15800 87th St NE
Otsego, MN 55330
Phone (763) 252-1316

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

6445 Richfield Pkwy
Richfield, MN 55423
Phone (612) 243-0201

21615 S Diamond Lake Rd
Rogers, MN 55374
Phone (763) 428-4831

14333 Highway 13 S
Savage, MN 55378
Phone (952) 226-1411

8900 Highway 7
St Louis Park, MN 55426
Phone (952) 933-4858

Interoperability endpoints

  • Direct secure messaging: mstallone495352@fairview.direct-ci.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1527465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1821589680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BENSON AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 99TH AVE N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694738",
            "telephone_number": "763-898-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 W 42nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10036",
            "country_code": "US",
            "telephone_number": "212-938-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALLONE",
        "first_name": "MEREDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-28",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.