NPIMap

Organization Active NPI

Brandt Opticare Inc

  • Optometrist
  • Moorhead, MN
National Provider Identifier
1952371130
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2018 Issued in MN
Legal business name
BRANDT OPTICARE INC
Practice address
725 Center Ave
Suite # 2
Moorhead, MN 56560-1961
Phone
(218) 233-2650
Fax
(218) 233-2928
NPI assigned
Jan 23, 2006
Last updated
Sep 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Authorized official

Name
Ronald D Brandt, ODNPI 1851514269
Title
Owner
Phone
(218) 233-2650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2018 MN Primary

Addresses

Primary practice location

725 Center Ave
Suite # 2
Moorhead, MN 56560-1961

Mailing address

725 Center Ave
Suite # 2
Moorhead, MN 56560-1961
Phone (218) 233-2650

Other identifiers 2

IdentifierTypeStateIssuer
8911OtherNDBCBS ND
967523000MedicaidMN

National Provider Directory

National Provider Directory

Locations

115 5th St N
Breckenridge, MN 56520
Phone (218) 643-9330

Practitioners & affiliated clinicians

Practitioners 3

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": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1952371130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CENTER AVE",
            "address_2": "SUITE # 2",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601961",
            "telephone_number": "218-233-2650",
            "fax_number": "218-233-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CENTER AVE",
            "address_2": "SUITE # 2",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601961",
            "telephone_number": "218-233-2650",
            "fax_number": "218-233-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDT OPTICARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-233-2650",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND",
            "identifier": "8911",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "967523000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.