DISTINCTIVE EYEWEAR (NPI# 1073750071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073750071 |
| Entity Type | Organization |
| Organization Name | DISTINCTIVE EYEWEAR |
| Practice Address |
18157 Carson Ct Nw Suite C Elk River MN 55330-3610 |
| Practice Telephone | 7634167600 |
| Practice Fax Number | 7632743449 |
| Mailing Telephone | 7634167600 |
| Mailing Fax Number | 7632743449 |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2011-01-04 |
| Authorized Official Name | JOHN S BERESTKA (OWNER) |
| Authorized Official Telephone | 7633834130 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
MN | Eye and Vision Services Providers | |
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215019823 | Distinctive Eyewear | Technician/Technologist | 2805 Campus Dr, Suite 105, Plymouth, MN 55441-2676 | 2006-10-20 |
| 1558443168 | Distinctive Eyewear | Technician/Technologist | 21395 John Milless Dr, Suite 200, Rogers, MN 55374-4402 | 2006-10-20 |
| 1033291612 | Distinctive Eyewear | Technician/Technologist | 5657 Duluth St, Golden Valley, MN 55422-4054 | 2006-10-20 |
| Street Address |
18157 CARSON CT NW SUITE C |
| City | ELK RIVER |
| State | MN |
| Zip Code | 55330-3610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881831782 | Northwest Eye Clinic, Pa | Ophthalmology | 18157 Carson Ct Nw, Suite C, Elk River, MN 55330-3610 | 2009-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504139 | Jacob Stevens | Pharmacist | 19216 Freeport Ave, Cub Pharmacy, Elk River, MN 55330 | 2020-07-01 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1346888609 | Katie Eberley | Counselor | 9425 Quantrelle Ave, Otsego, MN 55330 | 2019-12-18 |
| 1649839986 | Jodi Marie Pikula | Massage Therapist | 710 Dodge Ave, Suite C, Elk River, MN 55330 | 2019-06-11 |
| 1144793878 | Northern Cities Therapy, Inc. | Counselor | 19230 Evans St Nw Ste 100, Elk River, MN 55330 | 2019-01-04 |
| 1144715236 | Jennifer Kay Dahlseid | Chiropractor | 200 5th St Nw Ste J, Elk River, MN 55330 | 2018-06-29 |
| 1124542089 | Megan Majsterski Lazere | Counselor | 9245 Quantrelle Avenue, Otsego, MN 55330 | 2017-08-01 |
| 1134674237 | Rescare Minnesota | Community Based Residential Treatment Facility, Mental Illness | 633 Upland Ave Nw, Elk River, MN 55330 | 2016-08-18 |
| 1356894927 | Allison Benz | Counselor | 9245 Quantrelle Ave, Otsego, MN 55330 | 2016-07-29 |
| 1447615141 | Laura Stevenson | Speech-Language Pathologist | 15990 90th St., Otsego, MN 55330 | 2015-12-22 |
| Find all providers in zip 55330 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881776334 | Wal-mart Stores, Inc. | Technician/Technologist | 18185 Zane St Nw, Elk River, MN 55330-4505 | 2006-10-20 |
| 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 |
| 1851712384 | Marshall Allan Daly | Technician/Technologist | 2484 University Ave W, Saint Paul, MN 55114-1735 | 2013-12-31 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.