Anna Lee Percival, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3727 Issued in MN

Practice address

4750 Washington SQ
White Bear Lake, MN 55110-3257

Phone

(651) 429-3379

NPI assigned

Jun 3, 2021

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

Illinois College of Optometry at Chicago, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doffin Family Eye Care PAGroup PAC ID 6608142898, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doffin Family Eye Care PA

  dba White Bear Eye Clinic and Optical

  • Optometrist
  • White Bear Lake, MN
  • NPI 1346291630
  Medicare reassignment Care Compare group NPD
• Minnesota Eye Consultants, PA

  • Ophthalmology Physician
  • Bloomington, MN
  • NPI 1508839879
  NPD (past)

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1972179547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 WASHINGTON SQ",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103257",
            "telephone_number": "651-429-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WASHINGTON SQ",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103257",
            "telephone_number": "651-429-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCIVAL",
        "first_name": "ANNA",
        "middle_name": "LEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace of Mind Home Care, LLC
• Peddycoart Chiropractic Inc.
• Brenwyn Anne Lisa Peddycoart, DC
• Teresa A Pena, MD
• Kathleen Jo Penn, LPCC
• Jessica Walker Perkins
• Danielle R Perry Ramirez, MD
• David Michael Perry, O.D.
• Christopher M Phillips, DPM.
• Phoenix Residence, Inc.

• Optometrist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.