DR RICHARD D BRUESCH, PA (NPI# 1912115999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912115999 |
| Entity Type | Organization |
| Organization Name | DR RICHARD D BRUESCH, PA |
| Practice Address |
200 12th St Sw Forest Lake MN 55025-1482 |
| Practice Telephone | 6514649767 |
| Practice Fax Number | 6514649062 |
| Mailing Telephone | 6514649767 |
| Mailing Fax Number | 6514649062 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2012-11-19 |
| Authorized Official Name | DR. RICHARD D BRUESCH (OPTOMETRIST) |
| Authorized Official Telephone | 6514649767 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | MN2622 | MN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | PREFERREDONE | 412481029770 | 01 |
| MN | UCARE | 167933 | 01 |
| MN | BCBS OF MN | 5C945BR | 01 |
| MN | MEDICA | 2201835 | 01 |
| MN | MEDICA | 21000260 | 01 |
| MN | BCBS OF MN | 5C946BR | 01 |
| Street Address |
200 12TH ST SW |
| City | FOREST LAKE |
| State | MN |
| Zip Code | 55025-1482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801813290 | Walmart Inc. | Pharmacy | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2006-07-16 |
| 1952909905 | Ashley Louise Augustine | Pharmacist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2020-10-13 |
| 1649878612 | Laura Marie Olson | Pharmacist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2020-10-13 |
| 1831749530 | Kelly J Marr | Pharmacist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2019-09-13 |
| 1255412243 | Wal-mart Stores, Inc. | Technician/Technologist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2006-10-18 |
| 1922119486 | Richard David Bruesch | Optometrist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2006-08-31 |
| 1003922030 | Roy William Backus | Optometrist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043846173 | Persistence Physical Therapy LLC | Clinic/Center | 2009 W Broadway Ave, Ste 400 Pmb 131, Forest Lake, MN 55025 | 2020-03-20 |
| 1255973319 | Connie Rettig | Technician | 908 North Shore Drive, Forest Lake, MN 55025 | 2019-10-10 |
| 1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
| 1669754735 | Brent Alan Millard | Pharmacist | 1207 West Broadway Ave, Forest Lake, MN 55025 | 2011-09-15 |
| 1982842167 | Lakes Center for Youth and Families | Community/Behavioral Health | 20 N Lake Street, Suite 103, Forest Lake, MN 55025 | 2009-01-27 |
| 1487843355 | Paul Luke Mladnick | Marriage & Family Therapist | 1068 So Lake St, #109, Forest Lake, MN 55025 | 2007-10-17 |
| 1740477678 | Rita Lynn Scanlan | Occupational Therapist | 604 Ne 1st St, Birchwood Health Care Center, Forest Lake, MN 55025 | 2007-09-25 |
| 1114053113 | Senior Care Forest Lake, LLC | Skilled Nursing Facility | 604 N.e. First Street, Forest Lake, MN 55025 | 2007-02-26 |
| 1073672101 | Catharine B Ruther | Dentist | 956 West Broadway, Lakes Dental Clinic, Forest Lake, MN 55025 | 2006-12-06 |
| 1407914849 | Ervin George Savord | Dentist | 255 Highway 97, Suite 1b, Forest Lake, MN 55025 | 2006-12-05 |
| Find all providers in zip 55025 | ||||
| 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 |
|---|---|---|---|---|
| 1295829752 | Gregory Donald Jones | Optometrist | Walmart Vision Ctr #2274, 200 Ksw 12th St, Forest Lake, MN 55025-1609 | 2006-10-02 |
| 1437254455 | Scott R Telander | Optometrist | 20 Lake St N, Suite 101, Forest Lake, MN 55025-2523 | 2006-09-14 |
| 1982735668 | Kari Lynn Eliason | Optometrist | 356 12th St Sw, Forest Lake, MN 55025-1749 | 2007-03-07 |
| 1669535308 | Sean Philip Bell | Optometrist | 356 12th St Sw, Forest Lake, MN 55025-1749 | 2006-12-17 |
| 1053473835 | Forest Lake Optometric Center | Optometrist | 20 Lake St N, Forest Lake, MN 55025-2523 | 2006-12-15 |
| 1558423731 | Kevin Lee Bahr | Optometrist | 20 Lake St N, #104, Forest Lake, MN 55025-2523 | 2006-12-14 |
| 1922119486 | Richard David Bruesch | Optometrist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2006-08-31 |
| 1003922030 | Roy William Backus | Optometrist | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2006-08-22 |
| 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 | FOREST LAKE |
| Zip Code | 55025 |
Please comment or provide details below to improve the information on DR RICHARD D BRUESCH, PA.
| 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.