DR. LESLIE R MASCIARELLI KISCH (NPI# 1699876417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699876417 |
| Entity Type | Individual |
| Full Name | DR. LESLIE R MASCIARELLI KISCH |
| Other Name | DR. LESLIE R MASCIARELLI |
| Credential | OD |
| Practice Address |
918 Washington Ave Optical Eyedeas Detroit Lakes MN 56501 |
| Mailing Address |
706 12th St Se Barnesville MN 56514-3960 |
| Practice Telephone | 2188478021 |
| Practice Fax Number | 2188469552 |
| Mailing Telephone | 2183547065 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 490 | ND | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 2319 | MN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 2202047 | 01 |
| MN | MEDICA | 2207652 | 01 |
| MN | BCBS | 36B56MA | 01 |
| MN | MEDICA | 2202048 | 01 |
| MN | BCBS | 283R7MA | 01 |
| MN | BCBS | 283R8MA | 01 |
| Street Address |
918 WASHINGTON AVE OPTICAL EYEDEAS |
| City | DETROIT LAKES |
| State | MN |
| Zip Code | 56501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962496570 | Richard N Kittelson | Technician/Technologist | 918 Washington Ave, Detroit Lakes, MN 56501-3402 | 2005-09-09 |
| 1790942332 | Richard Neal Kittelson | Technician/Technologist | 918 Washington Ave, Detroit Lakes, MN 56501-3402 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
| 1992179386 | Compassion House | Substance Abuse Rehabilitation Facility | 811 8th St. Se, Detroit Lakes, MN 56501 | 2015-11-23 |
| 1720344286 | Lakes Crisis & Resource Center | Clinic/Center | 1339 Pelican Lane, Detroit Lakes, MN 56501 | 2012-04-09 |
| 1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
| 1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
| 1760651079 | Rapidcare Urgent Care Pllc | Family Medicine | 1361 Wenner Road, Detroit Lakes, MN 56501 | 2008-02-21 |
| 1427274729 | Jeffrey C Gregory | Psychologist | 910 Lincoln Ave, Detroit Lakes, MN 56501 | 2007-04-17 |
| 1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
| Find all providers in zip 56501 | ||||
| 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 |
|---|---|---|---|---|
| 1164517348 | Morrison Eye Care Optometrists, P.a. | Optometrist | 1244 Washington Ave, Detroit Lakes, MN 56501-3906 | 2006-10-04 |
| 1396745550 | Dale K Hoffmann | Optometrist | 1583 Highway 10 W, Detroit Lakes, MN 56501-2232 | 2005-07-28 |
| 1063797116 | Alexander Earl Moses | Optometrist | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2011-10-19 |
| 1871825364 | Lakes Vision, PC | Optometrist | 1583 Highway 10 W, Detroit Lakes, MN 56501-2232 | 2010-02-08 |
| 1548490055 | Dale Hoffmann, P.C. | Optometrist | 1583 Highway 10 W, Detroit Lakes, MN 56501-2232 | 2009-07-17 |
| 1861475709 | Craig A Bratvold | Optometrist | 1583 Highway 10 W, Detroit Lakes, MN 56501-2232 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615069 | Eagan Eye Clinic LLC | Optometrist | 12390 Sherburne Ave, Becker, MN 55308-9147 | 2020-10-02 |
| 1750998100 | Infinity Eye Care | Optometrist | 1275 Ramsey St Ste 700, Shakopee, MN 55379-3131 | 2020-09-29 |
| 1831700798 | Muychi Timothy Vang | Optometrist | 11217 Commerce Dr N, Champlin, MN 55316-3122 | 2020-08-13 |
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1699399592 | Nicole Rene Schmiedt | Optometrist | 400 Selby Ave Apt 221, Saint Paul, MN 55102-4509 | 2020-06-05 |
| 1700409885 | Russell N Osnes Od & Associates Pa | Optometrist | 1340 Duckwood Dr Ste 14, Eagan, MN 55123-2324 | 2020-05-22 |
| 1225657067 | Viginia Ho | Optometrist | 680 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-04-12 |
| 1992331359 | Megan Kaye Horter | Optometrist | 1 Veterans Dr # 100-77, Minneapolis, MN 55417-2309 | 2020-03-18 |
| 1639704232 | Barton Eye Care LLC | Optometrist | 2306 S Broadway St Ste 12, Alexandria, MN 56308-1883 | 2020-03-04 |
| Find all providers with the same taxonomy | ||||
| City | DETROIT LAKES |
| Zip Code | 56501 |
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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.