Minnesota Eyecare Network Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

MINNESOTA EYECARE NETWORK INC.

Doing business as

Perham Eye Clinic

Practice address

340 Fox Street
Perham, MN 56573

Phone

(218) 346-3310

Fax

(218) 346-9064

NPI assigned

Apr 23, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy C Neitzke, ODNPI 1033133517

Title

President

Phone

(218) 346-3310

Specialties & licenses 1

Addresses

Other names 1

• Perham Eye Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Minnesota Eyecare Network, Inc

  dba Azure Vision Care

  • Optometrist
  • Perham, MN
  • NPI 1407960651

  O20100930051324

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Charles Neitzke, OD

  • Optometrist
  • Perham, MN
  • NPI 1033133517
  Authorized official Same address or phone

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861610131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 FOX STREET",
            "address_2": "PO BOX 18",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "56573",
            "telephone_number": "218-346-3310",
            "fax_number": "218-346-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 FOX STREET",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "56573",
            "telephone_number": "218-346-3310",
            "fax_number": "218-346-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA EYECARE NETWORK INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NEITZKE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-346-3310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perham Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miranda Matis
• Evalyn McCleary
• Lisa Meader, RD
• Ava Larae Melideo-Fitch
• Michael L Hamann DDS PA
• Minnesota Eyecare Network, Inc (Azure Vision Care)
• Carissa Marie Mitchell, D.C.
• Nicholas Michael Mitchell, D.C.
• Lisa Moe
• Elijah Morris

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.