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MINNESOTA VISION OUTREACH INC NPI 1457563827


NPI Information

NPI: 1457563827
Provider Name: MINNESOTA VISION OUTREACH, INC
Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 24D0916444

Address:
9905 45TH AVENUE NORTH
SUITE 110
PLYMOUTH, MN
ZIP 55422
Phone: (763) 595-8414
Get Directions

MINNESOTA VISION OUTREACH, INC is an optometrist in Plymouth, MN. The provider is 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. MINNESOTA VISION OUTREACH, INC NPI is 1457563827. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9905 45TH AVENUE NORTH
SUITE 110
PLYMOUTH, MN
ZIP 55422-315
Phone: (763) 595-8414
Fax: (763) 595-8414

The provider's authorized official is Samuel Wolfson .
The authorized official title is Owner and has the following contact phone number (763) 585-8414.

The CLIA number assigned to this NPI record is 24D0916444 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/5/2007 and was last updated on 11/10/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometrist1706MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13C780MIOTHERMINNESOTABLUE PLUS
2096744100MEDICAIDMINNESOTA
32115998OTHERMINNESOTAMEDICA CHOICE
40909390001MEDICARE PINMINNESOTA
5102877OTHERMINNESOTAUCARE
619467WOOTHERMINNESOTABCBS OF MN
723979OTHERMINNESOTAHEALTH PARTNERS
82499537OTHERMINNESOTAMHP
92100002OTHERMINNESOTAMEDICA PRIMARY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.