| Four Seasons Eyecare | |
|
4455 Highway 169 N, Plymouth, MN 55442-2897 | |
| (763) 559-7358 | |
| (763) 559-2167 |
| Full Name | Four Seasons Eyecare |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 4455 Highway 169 N, Plymouth, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497785620 | NPI | - | NPPES |
| 496562100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2103 (Minnesota) | Primary |
| Provider Name | Kristina Borespupp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831159680 PECOS PAC ID: 4082654132 Enrollment ID: I20050509000028 |
| Provider Name | Donald H Sealock |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427018266 PECOS PAC ID: 2466492699 Enrollment ID: I20101104001661 |
| Provider Name | Matthew Kyle Anderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326488008 PECOS PAC ID: 3678709565 Enrollment ID: I20131125000606 |
| Provider Name | Lauren Marie Evans |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790458081 PECOS PAC ID: 3678979945 Enrollment ID: I20210913000307 |
| Provider Name | Bryce D Sealock |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831829100 PECOS PAC ID: 3971975483 Enrollment ID: I20230209002683 |
| Provider Name | Nicole A Solem |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073181574 PECOS PAC ID: 8921401134 Enrollment ID: I20231121000406 |
| Mailing Address | Practice Location Address |
|---|---|
| Four Seasons Eyecare 4455 Highway 169 N, Plymouth, MN 55442-2897 Ph: (763) 559-7358 | Four Seasons Eyecare 4455 Highway 169 N, Plymouth, MN 55442-2897 Ph: (763) 559-7358 |
Grant Sealock, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4455 Highway 169 N, Plymouth, MN 55442 Phone: 763-559-7358 Fax: 763-559-2167 | |
Kenndy Vision Health Center Optometrist Medicare: Medicare Enrolled Practice Location: 10600 Old County Road 15, Plymouth, MN 55441 Phone: 763-545-8850 Fax: 763-544-1257 | |
John Mueller Od Pc Optometrist Medicare: Medicare Enrolled Practice Location: 4190 Vinewood Ln N Ste 109, Plymouth, MN 55442 Phone: 763-559-5522 Fax: 763-559-7122 | |
Nicole Ann Solem, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4455 Highway 169 N, Plymouth, MN 55442 Phone: 763-559-7358 | |
Dr. Kelsey Moore, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 10600 Old County Road 15, Plymouth, MN 55441 Phone: 763-545-8850 Fax: 763-544-1257 | |
Visionsmith Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4190 Vinewood Ln N, Suite 109, Plymouth, MN 55442 Phone: 763-559-5522 Fax: 763-559-7122 | |
Dr. Nadia Siddiqi Khan, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3007 Harbor Ln N Ste 1500, Plymouth, MN 55447 Phone: 763-559-4669 Fax: 763-559-4767 |