| |
4051 W Division St Ste A, Saint Cloud, MN 56301-3741 | |
(320) 253-5994 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 4051 W Division St Ste A, Saint Cloud, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942866371 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Provider Name | Eric L Saksa |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1558477893 PECOS PAC ID: 0749180578 Enrollment ID: I20040109000390 |
Provider Name | Ara C Gerard |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1841356532 PECOS PAC ID: 1254234636 Enrollment ID: I20040202000257 |
Provider Name | James B Connelly |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1508884016 PECOS PAC ID: 2769474311 Enrollment ID: I20040401001540 |
Provider Name | Andrea K Zipprich |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1033214473 PECOS PAC ID: 1355333923 Enrollment ID: I20040401001635 |
Provider Name | Glenn O Kallevig |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1174688725 PECOS PAC ID: 1355333956 Enrollment ID: I20040402000006 |
Provider Name | Joseph J Kisch |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1982713012 PECOS PAC ID: 5799767919 Enrollment ID: I20040602000943 |
Provider Name | Leann Sundhagen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770694986 PECOS PAC ID: 8325021108 Enrollment ID: I20040611000717 |
Provider Name | James T Hess |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1720017304 PECOS PAC ID: 8426003724 Enrollment ID: I20050321000206 |
Provider Name | Robert T Mccamy |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1497892335 PECOS PAC ID: 7517904097 Enrollment ID: I20050415000524 |
Provider Name | Paul Dubbels |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235339953 PECOS PAC ID: 8426089764 Enrollment ID: I20050825000874 |
Provider Name | Colleen N Konkel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1528018975 PECOS PAC ID: 4587693460 Enrollment ID: I20060127000471 |
Provider Name | Lori R Vikesland Obler |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1114930989 PECOS PAC ID: 4486660388 Enrollment ID: I20060302000057 |
Provider Name | Kenneth Ristau |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235180233 PECOS PAC ID: 5092727586 Enrollment ID: I20060627000337 |
Provider Name | Bryan D Lorenz |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1881634806 PECOS PAC ID: 3476566464 Enrollment ID: I20060714000276 |
Provider Name | Londa L Fischer Costello |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1942401039 PECOS PAC ID: 5799879771 Enrollment ID: I20070921000127 |
Provider Name | Michael B Fisher |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1891884771 PECOS PAC ID: 8325134117 Enrollment ID: I20080124000219 |
Provider Name | April A Austing |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1427288554 PECOS PAC ID: 1254486582 Enrollment ID: I20090909000690 |
Provider Name | Jacqueline A Jones |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1023090396 PECOS PAC ID: 0345380879 Enrollment ID: I20091215000113 |
Provider Name | Ryan D Johnson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1093948259 PECOS PAC ID: 2567502727 Enrollment ID: I20091218000294 |
Provider Name | Kristina A Voyna |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1457303505 PECOS PAC ID: 3971506627 Enrollment ID: I20110429000559 |
Provider Name | Gareth S Hataye |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164529384 PECOS PAC ID: 1658418355 Enrollment ID: I20120118000302 |
Provider Name | Jacob Bollman |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811336043 PECOS PAC ID: 3274767454 Enrollment ID: I20131001000083 |
Provider Name | Lois M Meacham |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902929391 PECOS PAC ID: 6709014111 Enrollment ID: I20140110000351 |
Provider Name | Jenna K Backowski |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1831502244 PECOS PAC ID: 8820212525 Enrollment ID: I20140620000095 |
Provider Name | Melissa Anna Shaffer |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1285833624 PECOS PAC ID: 5395830335 Enrollment ID: I20150918000124 |
Provider Name | Ashley L Walkoviak |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1043699317 PECOS PAC ID: 0244547347 Enrollment ID: I20150922003347 |
Provider Name | Aimee Violette |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1578026738 PECOS PAC ID: 3173859881 Enrollment ID: I20200601001107 |
Provider Name | Ronald L Mccann |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1609925692 PECOS PAC ID: 0941215388 Enrollment ID: I20200727003178 |
Provider Name | Steven Laliberte |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467442582 PECOS PAC ID: 8224926829 Enrollment ID: I20200803002908 |
Provider Name | Rebecca Sue Weisbeck |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104057116 PECOS PAC ID: 2466879523 Enrollment ID: I20200903001483 |
Provider Name | Brianne Herlitzke |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1992268551 PECOS PAC ID: 8022342229 Enrollment ID: I20200929002812 |
Provider Name | Taylor Davis |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1306411731 PECOS PAC ID: 4183024763 Enrollment ID: I20210618001386 |
Provider Name | Katie Aksoy |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164092383 PECOS PAC ID: 8123422300 Enrollment ID: I20210810002741 |
Provider Name | Christina Nguyen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1407478969 PECOS PAC ID: 8123449931 Enrollment ID: I20211005001263 |
Provider Name | Adam M Peters |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1851063952 PECOS PAC ID: 6103215116 Enrollment ID: I20220125000744 |
Provider Name | Josephine R Ausdemore |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104564269 PECOS PAC ID: 3678954856 Enrollment ID: I20220719002966 |
Provider Name | Samuel Elijah Lupkes |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1689382020 PECOS PAC ID: 0244609238 Enrollment ID: I20221214001362 |
Provider Name | Linda Shi |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1700301231 PECOS PAC ID: 4688940679 Enrollment ID: I20221230000735 |
Provider Name | Wendy Lawson Kopp |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1669581765 PECOS PAC ID: 6507858503 Enrollment ID: I20230623001182 |
Provider Name | Emmalee Elaine Bardwell |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1992483648 PECOS PAC ID: 2466814868 Enrollment ID: I20230817000416 |
Provider Name | Mindy Kay Niemeier |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1841502762 PECOS PAC ID: 4587010129 Enrollment ID: I20231102000876 |
Provider Name | Stephen Sternitzky |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790768968 PECOS PAC ID: 3971628736 Enrollment ID: I20231102003892 |
Mailing Address | Practice Location Address |
---|---|
Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | 4051 W Division St Ste A, Saint Cloud, MN 56301-3741 Ph: (320) 253-5994 |