Wendy Seyller, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2105 Issued in MN

Practice address

13481 60TH St N Suite 200
St Croix Vision Center
Stillwater, MN 55082

Phone

(651) 439-6400

Fax

(651) 439-6405

NPI assigned

Oct 4, 2006

Last updated

Jan 30, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Indiana University - School of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eye U PLLC

  • Optometrist
  • Stillwater, MN
  • NPI 1902237258
  Medicare reassignment NPD Authorized official
• St Croix Vision Center Inc.

  • Optometrist
  • Stillwater, MN
  • NPI 1518059526
  NPD (past)
• Pearle Vision Inc

  dba Pearle Vision #C6672

  • Eyewear Supplier
  • Fairview Heights, IL
  • NPI 1982744033
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1891881512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 GRIFFIN AVE",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151509",
            "telephone_number": "651-493-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13481 60TH ST N SUITE 200",
            "address_2": "ST CROIX VISION CENTER",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "55082",
            "telephone_number": "651-439-6400",
            "fax_number": "651-439-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYLLER",
        "first_name": "WENDY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3C312SE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670360700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED / COLE VISION",
            "identifier": "11960",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Senior Helpers Care Team, LLC (Senior Helpers)
• Rosemary Ann Senjem, MA LAMFT
• Kellie Ann Seth, D.C.
• Sandra Severin, COTA
• Eileen Brigid Sexton, PH.D., LP
• Sandra Jean Shadley, R.N.
• Shana Link Counseling, LLC
• Shante PLLC (Frontline Mental Health and Wellness)
• Mary Margaret Sharkey
• Jacquelyn Sue Shaver, M.S CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.