Active NPI
Ai Soundara, O.D.
- Optometrist
- St Louis Park, MN
National Provider Identifier
1912286584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3253
- Practice address
- 3745 Louisiana Ave S
St Louis Park, MN 55426-4361 - Phone
- (952) 926-1775
- Fax
- (952) 926-3845
- NPI assigned
- Aug 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3253 | MN | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 3253 | MN |
Addresses
Primary practice location
3745 Louisiana Ave S
St Louis Park, MN 55426-4361
Mailing address
3745 Louisiana Ave S
St Louis Park, MN 55426-4361
Phone (952) 926-1775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3253 | MN | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313107200000",
"number": "1912286584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3745 LOUISIANA AVE S",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554264361",
"telephone_number": "952-926-1775",
"fax_number": "952-926-3845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3745 LOUISIANA AVE S",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554264361",
"telephone_number": "952-926-1775",
"fax_number": "952-926-3845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUNDARA",
"first_name": "AI",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-12",
"last_updated": "2011-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3253",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "MN",
"license": "3253",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.