Minnesota Eye Institute, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

31849 Issued in MN

Legal business name

MINNESOTA EYE INSTITUTE, INC.

Practice address

3401 S Broadway
Alexandria, MN 56308-3477

Phone

(320) 759-2020

Fax

(320) 759-2424

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Kent A Carlson, MDNPI 1518953306

Title

Owner

Phone

(320) 759-2020

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kent Arthur Carlson, MD

  • Ophthalmology Physician
  • Alexandria, MN
  • NPI 1518953306
  Medicare reassignment Care Compare group NPD Authorized official
• Casey William Bateman, O.D.

  • Optometrist
  • Stillwater, MN
  • NPI 1720439466
  Medicare reassignment Care Compare group NPD
• Patricia C Nelson, M.D.

  • Ophthalmology Physician
  • El Paso, TX
  • NPI 1093944225

  MN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1841316627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 S BROADWAY",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083477",
            "telephone_number": "320-759-2020",
            "fax_number": "320-759-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 S BROADWAY",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083477",
            "telephone_number": "320-759-2020",
            "fax_number": "320-759-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA EYE INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-759-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "31849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43Q15MI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK4923",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "56221",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "727602800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "E076",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie J Miller, LRD,CDE
• Kaylee Miller, DPM
• Riley Miller
• Scott Minnerath, OD
• Minnesota Eye Institute Surgery Center, LLC
• Minnesota Teen Challenge, Inc
• Minnesota Teen Challenge, Inc
• Michelle C Mirau, MD
• Jacquelyn J Miron, R.PH
• Shanna Mitchell

• Specialist in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.