ROSEVILLE OPTICIANS (NPI# 1992937338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992937338 |
| Entity Type | Organization |
| Organization Name | ROSEVILLE OPTICIANS |
| Practice Address |
1790 Lexington Ave N Saint Paul MN 55113-6167 |
| Practice Telephone | 6514898800 |
| Mailing Telephone | 6514898800 |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2009-08-19 |
| Authorized Official Name | ROBERT B KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 6514898800 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | KENNEDY EYE ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BC/BS OF MN | 27620RO | 01 |
| Street Address |
1790 LEXINGTON AVE N |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55113-6167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134696990 | Diamond Adult Day Services LLC | Clinic/Center | 1790 Lexington Ave N, Saint Paul, MN 55113-6167 | 2018-10-30 |
| 1013127281 | Kennedy Eye Associates | Optometrist | 1790 Lexington Ave N, Saint Paul, MN 55113-6167 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851712384 | Marshall Allan Daly | Technician/Technologist | 2484 University Ave W, Saint Paul, MN 55114-1735 | 2013-12-31 |
| 1285937862 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1360 University Ave W Ste 106, Saint Paul, MN 55104-4092 | 2010-12-21 |
| 1831361302 | Teri Rachel Focht | Technician/Technologist | 944 Euclid St, Saint Paul, MN 55106-5615 | 2008-03-25 |
| 1003935867 | Grand Spectacle Inc | Technician/Technologist | 764 Grand Ave, Saint Paul, MN 55105-3306 | 2007-03-29 |
| 1619472545 | Wade Nooleen | Technician/Technologist | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2018-03-23 |
| 1043627466 | Grace Vision, Inc Dba Pearle Vision | Technician/Technologist | 3001 White Bear Ave N, Suite 1050, Saint Paul, MN 55109-1215 | 2014-07-17 |
| 1386883254 | James Edward Johnson | Technician/Technologist | 101 5th St E Ste 281, Saint Paul, MN 55101-1862 | 2009-02-16 |
| 1821171430 | Wal-mart Stores, Inc. | Technician/Technologist | 1644 Robert St S, Saint Paul, MN 55118-3918 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821558370 | National Vision Inc | Technician/Technologist | 8348 Highway 7, Saint Louis Park, MN 55426-3907 | 2019-03-21 |
| 1861937112 | Personality Eyewear | Technician/Technologist | 8257 Logan Ave N, Brooklyn Park, MN 55444-1545 | 2016-12-22 |
| 1871961185 | Wal-mart Stores, Inc | Technician/Technologist | 3001 E Highway 7, Montevideo, MN 56265-4556 | 2015-09-03 |
| 1215316682 | National Vision, Inc. | Technician/Technologist | 12940 Riverdale Dr Nw, Ste 300, Coon Rapids, MN 55448-8412 | 2015-05-19 |
| 1619354156 | National Vision, Inc. | Technician/Technologist | 1727 Beam Ave, Ste D, Maplewood, MN 55109-1164 | 2015-05-05 |
| 1124437223 | America's Best Contacts & Eyeglasses | Technician/Technologist | 6096 Shingle Creek Pkwy, Brooklyn Center, MN 55430-2316 | 2014-08-04 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1174966683 | David Yang | Technician/Technologist | 987 Oday St S, Maplewood, MN 55119-5953 | 2013-04-15 |
| 1063760817 | Wal-mart Stores Inc | Technician/Technologist | 1200 Shingle Creek Crossing, Brooklyn Center, MN 55430 | 2012-08-28 |
| 1639425952 | Optical Services Direct LLC | Technician/Technologist | 10524 Kimbro Ave S, Cottage Grove, MN 55016-4150 | 2012-07-24 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55113 |
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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.