Carly Van Keulen

Primary specialty

OptometristTaxonomy code 152W00000X

License

4011 Issued in MN

Practice address

150 17TH Ave NW
Rochester, MN 55901-0321

Phone

(507) 288-6964

NPI assigned

Apr 12, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Byron Eye CareGroup PAC ID 9931412087, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Byron Eye Care

  • Optometrist
  • Byron, MN
  • NPI 1528456274
  Medicare reassignment Care Compare group NPD
• Gibbons Optical, LLC

  • Eyewear Supplier
  • Rochester, MN
  • NPI 1851585822
  Medicare reassignment NPD

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

{
    "created_epoch": "1744416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1861287583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 4TH ST NE STE 350",
            "city": "BYRON",
            "state": "MN",
            "postal_code": "559205004"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1067 4th St NE Ste 350",
            "address_purpose": "LOCATION",
            "city": "Byron",
            "state": "MN",
            "postal_code": "559205004",
            "country_code": "US",
            "telephone_number": "507-775-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN KEULEN",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-12",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "4011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte S Van Dorn, MD
• Christine Lynn Van Dyke, FNP
• Hailey Grace Van Eijl
• Faith Donelle Van Erp
• James M Van Ess, DDS, M.D.
• Ross B Van Natta, MSPT
• Emma Rose Van Reysen, PHARMD, MBA
• Andrew Dean Van Ruler, MS, LPCC, LADC
• Velvet Van Ryan, APRN-CNP
• Jeremy Shane Van Tassel, LADC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.