Penny P Vizina, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2381 Issued in MN

Practice address

2560 Harvest LN
Owatonna, MN 55060-4305

Phone

(507) 451-3072

Fax

(507) 451-4291

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Penny Lynn Peterson Former name

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

Pacific University - College of Optometry, 1991

Medicare assignment

May accept Medicare assignment

Group practices

Gilthvedt Eyecare Clinic IncGroup PAC ID 6305888678, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Gilthvedt Eyecare Clinic, Inc

  • Optometrist
  • Owatonna, MN
  • NPI 1437175882
  Medicare reassignment Care Compare group NPD
• Family Vision Care P.a.

  • Eyewear Supplier
  • Owatonna, MN
  • NPI 1144490384
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1962597112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 HARVEST LN",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604305",
            "telephone_number": "507-451-3072",
            "fax_number": "507-451-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 HARVEST LN",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604305",
            "telephone_number": "507-451-3072",
            "fax_number": "507-451-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZINA",
        "first_name": "PENNY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003736",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3108975",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "900A760100",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "PETERSON",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melody Kay Vanhoudt, LPN
• Adrienne Vanzomeren, PH.D., L.P.
• Via Orthopedics, LLC
• Nicholas Clinton Vincelli, O.D.
• Eleanor O Vita, MD
• Stephanie Voegele, LICSW
• Madison Beret Vonruden, OTR/L
• Bryan Michael Voracek, PA, ATC
• Wal-Mart Stores, Inc.
• Walgreen Co

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.