James Robert Gutfleisch, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

LD1848000 Issued in MN

Practice address

710 Division St-South
Suite a
Northfield, MN 55057-2468

Phone

(507) 645-2261

Fax

(507) 786-9703

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• River Valley Eye Associates Inc.

  • Eyewear Supplier
  • Northfield, MN
  • NPI 1508951765
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1982600524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 DIVISION ST S",
            "address_2": "STE A",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572468",
            "telephone_number": "507-645-2261",
            "fax_number": "507-786-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 DIVISION ST-SOUTH",
            "address_2": "SUITE A",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572468",
            "telephone_number": "507-645-2261",
            "fax_number": "507-786-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTFLEISCH",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "LD1848000",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "LD1848000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "177K2GU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "526004",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE, MN",
            "identifier": "106257",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6463231-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Granquist, MA, LPCC
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• Jennifer L Grossman, PA
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• Robyn Gunderson, PHD
• Bridget Haala
• Cassandra Haffner
• Tricia Hagedorn, PHARMD, BCOP
• Annelies Karon Hagemeister, PHD, MSW
• Daniel Henry Hagen, ATC

• All providers in Northfield, MN
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.