Organization Active NPI

Alexandria Eye Clinic P.a.

  • Clinic/Center
  • Alexandria, MN
National Provider Identifier
1932167772
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
20870 Issued in MN
Legal business name
ALEXANDRIA EYE CLINIC P.A.
Practice address
2600 Jefferson St Ste 200
Alexandria, MN 56308-3410
Phone
(320) 762-2166
Fax
(605) 371-7199
NPI assigned
May 2, 2006
Last updated
May 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Mark Allen Scharnberg
Title
Cfo
Phone
(605) 359-9155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 20870 MN Primary

Addresses

Primary practice location

2600 Jefferson St Ste 200
Alexandria, MN 56308-3410

Mailing address

3101 W 57TH St
Sioux Falls, SD 57108-3162
Phone (605) 371-7100

Other identifiers 1

IdentifierTypeStateIssuer
242392800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070530000293 MN Part B Supplier - Clinic/Group Practice 0143327031 Receives reassigned benefits from 6 practitioners
Practice locations: Alexandria, MN

National Provider Directory

National Provider Directory

Locations

1501 Hawthorne St
Alexandria, MN 56308
Phone (320) 355-0953

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1932167772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571083162",
            "telephone_number": "605-371-7100",
            "fax_number": "605-371-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 JEFFERSON ST STE 200",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083410",
            "telephone_number": "320-762-2166",
            "fax_number": "605-371-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA EYE CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "SCHARNBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-359-9155"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "20870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242392800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.