Individual provider Active NPI

Andrew Jon Sweeter, OD

  • Optometrist
  • Maple Grove, MN
National Provider Identifier
1841020302
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3954 Issued in MN
Practice address
13195 Weaver Lake Rd
Maple Grove, MN 55369-9410
Phone
(763) 420-5112
NPI assigned
Aug 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3954 MN Primary

Addresses

Primary practice location

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410

Mailing address

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410
Phone (763) 420-5112

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
I20240916002808 MN Practitioner - Optometry 3072054238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Brokea Inc.Group PAC ID 9537328075, 8 clinicians

Practice addresses (Care Compare)

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410
Phone (763) 420-5112

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3945MNMDMental Health Counselor
3954MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brokea Inc. Optometrist CurrentSince Aug 1, 2024 Accepting new patients

Locations

13195 Weaver Lake Rd
Maple Grove, MN 55369
Phone (763) 420-5112

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": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1841020302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "763-420-5112",
            "fax_number": "763-420-6957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "763-420-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEETER",
        "first_name": "ANDREW",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-07",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.