Gibbons Optical, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

2343 Issued in MN

Legal business name

GIBBONS OPTICAL, LLC

Practice address

150 17TH Ave NW
Rochester, MN 55901-0321

Phone

(507) 288-6964

Fax

(507) 252-5307

NPI assigned

Aug 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Karen Marie Bjorngaard, O.D.NPI 1588799761

Title

Optometrist

Phone

(507) 288-6964

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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

• Karen Marie Bjorngaard, O.D.

  • Optometrist
  • Rochester, MN
  • NPI 1588799761
  Medicare reassignment Care Compare group NPD Authorized official
• Blair Gregory Seelhammer, O.D.

  • Optometrist
  • Rochester, MN
  • NPI 1184682668
  Medicare reassignment Care Compare group NPD
• Carly Van Keulen

  • Optometrist
  • Rochester, MN
  • NPI 1861287583
  Medicare reassignment NPD

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1851585822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 17TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559010321",
            "telephone_number": "507-288-6964",
            "fax_number": "507-252-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 17TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559010321",
            "telephone_number": "507-288-6964",
            "fax_number": "507-252-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBBONS OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "BJORNGAARD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "507-288-6964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "2343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691325300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Subha Ghosh
• Wissam Ghusn, MD
• Joseph Giacalone, MD
• Caterina Giannini, M.D.
• Megan Elizabeth Giarratana, DPT
• Raymond J Gibbons, M.D.
• Waleed Gibreel, MBBS
• Dylan Jacob Gibson, DPT
• Jeremy Brendon Gibson, D.O.
• Jill Carolyn Gibson, R.PH.

• Eyewear Supplier in Rochester, MN
• Providers in Rochester, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.