Active NPI
Roseville Opticians
- Optician
- Saint Paul, MN
National Provider Identifier
1992937338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Legal business name
- ROSEVILLE OPTICIANS
- Practice address
- 1790 Lexington Ave N
Saint Paul, MN 55113-6167 - Phone
- (651) 489-8800
- NPI assigned
- Aug 19, 2009
- Organization subpart
- Yes
- Parent organization
- KENNEDY EYE ASSOCIATES
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert B Kennedy, O.D.
- Title
- President
- Phone
- (651) 489-8800
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
1790 Lexington Ave N
Saint Paul, MN 55113-6167
Mailing address
1790 Lexington Ave N
Saint Paul, MN 55113-6167
Phone (651) 489-8800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27620RO | Other | MN | BC/BS OF MN |
National Provider Directory
National Provider Directory- Part of
- Roseville Opticians
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Optometrist
- Saint Paul, MN
- NPI 1013127281
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Roseville, MN
- NPI 1023000312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1250640000000",
"number": "1992937338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 LEXINGTON AVE N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551136167",
"telephone_number": "651-489-8800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1790 LEXINGTON AVE N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551136167",
"telephone_number": "651-489-8800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROSEVILLE OPTICIANS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KENNEDY EYE ASSOCIATES",
"enumeration_date": "2009-08-19",
"last_updated": "2009-08-19",
"status": "A",
"authorized_official_last_name": "KENNEDY",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "651-489-8800",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MN",
"identifier": "27620RO",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.