NPIMap

Organization Active NPI

Fairview Express Care

  • Eyewear Supplier
  • Andover, MN
National Provider Identifier
1861674665
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
FAIRVIEW EXPRESS CARE
Practice address
13819 Hanson Blvd NW
Andover, MN 55304-7608
Phone
(763) 572-5700
Fax
(763) 392-4052
NPI assigned
Dec 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Maureen V Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

13819 Hanson Blvd NW
Andover, MN 55304-7608

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other identifiers 2

IdentifierTypeStateIssuer
45Q12COOtherMNBCBS DME NUMBER
819418000MedicaidMN

Other names 1

  • M Health Fairview Clinic - Andover Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081028000548 MN Part B Supplier - Clinic/Group Practice 3375645179 Receives reassigned benefits from 4,146 practitioners
This NPI is an additional NPI on the enrollment
O20220315002388 MN DME Supplier - Physician - Optometrist 3375645179 Practice locations: Andover, MN

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Fairview Express Care20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

600 W 98th St
Ste 390
Minneapolis, MN 55420
Phone (952) 460-4900

Practitioners & affiliated clinicians

Practitioners 1,982

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

View all 1,982

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1861674665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "612-672-6740",
            "fax_number": "612-884-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13819 HANSON BLVD NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553047608",
            "telephone_number": "763-572-5700",
            "fax_number": "763-392-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW EXPRESS CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DME NUMBER",
            "identifier": "45Q12CO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "819418000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M Health Fairview Clinic - Andover",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Andover, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.