Kimberley Anne Bugajski, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

LD2371000 Issued in MN

Practice address

10600 Old County Road 15
Plymouth, MN 55441-6210

Phone

(763) 545-8850

Fax

(763) 544-1257

NPI assigned

Sep 26, 2006

Last updated

Dec 10, 2008By the provider in NPPES

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

Other identifiers 4

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

Illinois College of Optometry at Chicago, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Vision Health Center LLCGroup PAC ID 9739173659, 7 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kimberley.bugajski@direct.revolutionehr.com

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.

• Kennedy Vision Health Center, LLC

  dba Kenndy Vision Health Center

  • Optometrist
  • Plymouth, MN
  • NPI 1033203963
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1962503524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 OLD COUNTY ROAD 15",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416210",
            "telephone_number": "763-545-8850",
            "fax_number": "763-544-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 OLD COUNTY ROAD 15",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416210",
            "telephone_number": "763-545-8850",
            "fax_number": "763-544-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUGAJSKI",
        "first_name": "KIMBERLEY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "LD2371000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "751525100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2200102",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "977521015898",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "417R5BU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Ray Brown, CRNA, DNAP
• Bruce Pearson PA (Natural Chiropractic Center)
• Andrea Bryan, PA-C
• Ondrea Lee Bryans, MS LMFT
• Philip Oppong Buabeng
• Kristen Alexa Burnett, PSY.D., LP
• Amy C Burt, DO
• Clayton Douglas Busch, MD
• Shaun Bush
• Allison K Buth, NP-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.