MEGAN MARIE SIS (NPI# 1013242197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013242197 |
| Entity Type | Individual |
| Full Name | MEGAN MARIE SIS |
| Credential | OD, MS, FAAO |
| Practice Address |
12170 Aberdeen St Ne Blaine MN 55449-4716 |
| Practice Telephone | 7637577000 |
| Practice Fax Number | 7637573328 |
| Mailing Telephone | 7637577000 |
| Mailing Fax Number | 7637573328 |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2019-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3315 | MN | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | OEG002668 | PA | Eye and Vision Services Providers |
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
3315 | MN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | LICENSE | OEG002668 | 01 |
| MN | LICENSE | 3315 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3340 Northdale Blvd Nw Ste 130, Coon Rapids, MN 554481623 | 7633900707 | 7632194242 |
| Street Address |
12170 ABERDEEN ST NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55449-4716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043363401 | Blaine Eye Clinic Optometrists, P.a. | Optometrist | 12170 Aberdeen St Ne, Blaine, MN 55449-4716 | 2007-01-19 |
| 1417462698 | Ashley Ann Berens | Optometrist | 12170 Aberdeen St Ne, Blaine, MN 55449 | 2017-12-09 |
| 1033403464 | Northland Hearing Center Inc | Audiologist-Hearing Aid Fitter | 12170 Aberdeen St Ne, Blaine, MN 55449-4716 | 2011-06-02 |
| 1265694715 | Breann Marie Forliti | Optometrist | 12170 Aberdeen St Ne, Blaine, MN 55449-4716 | 2008-06-26 |
| 1548469737 | Rosamond Hannah Tedesco | Optometrist | 12170 Aberdeen St Ne, Blaine, MN 55449 | 2007-07-17 |
| 1013060409 | Lynn Alan Sulerud | Optometrist | 12170 Aberdeen St Ne, Blaine, MN 55449-4716 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736368 | Landon Thomas Case | Dentist | 10729 Town Square Drive Ne, Ste 100, Blaine, MN 55449 | 2020-07-02 |
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1841776242 | Kristin Broback | Nurse Practitioner | 10705 Town Square Dr Ne #100, Blaine, MN 55449 | 2018-07-18 |
| 1043719016 | Robin Lynn Broen | Registered Nurse | 3012 129th Ave Ne, Blaine, MN 55449 | 2018-02-06 |
| 1194197368 | Lund Health Professional Corporation | Chiropractor | 1360 101st Ave Ne, Suite 140, Blaine, MN 55449 | 2015-10-27 |
| 1871989806 | Blaine Wp II, LLC | Assisted Living Facility | 12402 Jamestown Street Ne, Blaine, MN 55449 | 2015-04-07 |
| 1154761633 | Jean Budge | Marriage & Family Therapist | 11800 Aberdeen Street Ne, Suite 100, Blaine, MN 55449 | 2013-06-28 |
| 1295013498 | Jeff K Yu | Veterinarian | 11850 Aberdeen St Ne, Blaine, MN 55449 | 2011-07-22 |
| 1528394707 | Julie Ann Eibensteiner | Physical Therapist | 11304 Davenport Circle Ne #a, Minneapolis, MN 55449 | 2009-10-23 |
| 1871725333 | Deborah Kathryn Zongo | Nurse Practitioner | 10190 Baltimore St Ne Ste 100, Blaine, MN 55449 | 2009-08-18 |
| Find all providers in zip 55449 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1225657067 | Viginia Ho | Optometrist | 680 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-04-12 |
| 1972773422 | Professional Vision Care, Pa | Optometrist | 1409 131st Ave Ne, Blaine, MN 55449-4108 | 2008-03-11 |
| 1245365253 | Bf Eye Care Ltd. | Optometrist | 10995 Club West Parkway, Suite 500, Blaine, MN 55449 | 2007-02-22 |
| 1043363401 | Blaine Eye Clinic Optometrists, P.a. | Optometrist | 12170 Aberdeen St Ne, Blaine, MN 55449-4716 | 2007-01-19 |
| 1932257284 | Angela M Musland | Optometrist | 1510 125th Ave Ne, Blaine, MN 55449-4749 | 2007-01-05 |
| 1992886519 | Robert Chous | Optometrist | 125 Northtown Dr Ne, Blaine, MN 55434-1036 | 2006-10-18 |
| 1770674160 | Allison Lynn Wiedemann | Optometrist | 570 Northtown Dr Ne, Blaine, MN 55434-1043 | 2006-09-28 |
| 1689785636 | Jean L Layman | Optometrist | 4405 Pheasant Ridge Dr Ne, Blaine, MN 55449-4531 | 2006-08-31 |
| 1295849917 | Chad M. Krietlow | Optometrist | 260 Northtown Dr Ne, Blaine, MN 55434-1037 | 2006-08-19 |
| Find all providers in BLAINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.