Katelyn J McDevitt, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3674 Issued in MN

Practice address

3840 Grand Way
St Louis Park, MN 55416-4788

Phone

(952) 848-2020

Fax

(952) 922-2015

NPI assigned

May 22, 2020

Sex

Female

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

University of Houston - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Optometric Eye Care Centers, P.a.

  • Optometrist
  • Fridley, MN
  • NPI 1548356595
  Medicare reassignment NPD
• Optometric Eye Care Centers, PA

  • Optometrist
  • Maple Grove, MN
  • NPI 1164861357
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Brooklyn Park, MN
  • NPI 1447668678
  NPD
• Optometric Eye Care Centers, PA

  • Optometrist
  • Maplewood, MN
  • NPI 1730203597
  NPD (past)

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1912520198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 GRAND WAY",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164788",
            "telephone_number": "952-848-2020",
            "fax_number": "952-922-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 GRAND WAY",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164788",
            "telephone_number": "952-848-2020",
            "fax_number": "952-922-2015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Market St Ste 190",
            "address_purpose": "LOCATION",
            "city": "Chanhassen",
            "state": "MN",
            "postal_code": "553174572",
            "country_code": "US",
            "telephone_number": "952-937-9465",
            "fax_number": "952-937-9332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDEVITT",
        "first_name": "KATELYN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quin McCormick
• Brenda Kay McCoy, MED
• Charles McCoy
• Lily McCoy
• Scott McDaniel, MD
• Erica Jennifer McDonald
• Karen M McDonald
• Karen McEiver, PHARM.D.
• Rory James Lee McFarlane
• Barbara Ruedy McGlynn, P.T.

• Optometrist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.