Brooke Heineman Bush, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3123 Issued in MN

Practice address

19022 Freeport St NW
#H
Elk River, MN 55330-4766

Phone

(763) 441-1055

NPI assigned

Jun 20, 2008

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 names 1

• Brooke Jasmine Heineman 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

Illinois College of Optometry at Chicago, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

D Stanton Enterprises LLCGroup PAC ID 6608964861, 4 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 and National Provider Directory roles.

• D. Stanton Enterprises, LLC

  • Optometrist
  • Rogers, MN
  • NPI 1063594109
  Medicare reassignment Care Compare group NPD
• I M I S Minnesota Inc

  • Optometrist
  • Minnetonka, MN
  • NPI 1043353949
  Medicare reassignment NPD
• Premier Eye Care, Cottage Grove, LTD

  • Optometrist
  • Cottage Grove, MN
  • NPI 1497792758
  NPD (past)
• Visionworks Inc

  • Eyewear Supplier
  • Omaha, NE
  • NPI 1205924792
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1992966022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 GOLFVIEW DR",
            "address_2": "APT. 2213",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232440",
            "telephone_number": "507-884-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19022 FREEPORT ST NW",
            "address_2": "#H",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304766",
            "telephone_number": "763-441-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "BROOKE",
        "middle_name": "HEINEMAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "HEINEMAN",
            "middle_name": "JASMINE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tasha Burg, MA
• Kirsten Jean Burgess
• Emily Burke-Hary
• Cheryl Lynnette Burlend, MD
• Mariah Jean Burris
• Rebecca Buttke, PT
• Calm Horizon Psychiatry Professional Limited Liability Company
• Taylor Joanne Campbell
• Carol Cantleberry, RN
• Taylor Lynn Carlson

• Optometrist in Elk River, MN
• Providers in Elk River, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.