BROECKER EYE & OPTICAL (NPI# 1114962529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114962529 |
| Entity Type | Organization |
| Organization Name | BROECKER EYE & OPTICAL |
| Practice Address |
2356 University Ave W Suite 260 Saint Paul MN 55114-1853 |
| Practice Telephone | 6516458124 |
| Practice Fax Number | 6516458125 |
| Mailing Telephone | 6516458124 |
| Mailing Fax Number | 6516458125 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STACEY T. BROECKER (OPTOMETRIST) |
| Authorized Official Telephone | 6516458124 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2108 | MN | Eye and Vision Services Providers |
| Street Address |
2356 UNIVERSITY AVE W SUITE 260 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55114-1853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922053040 | Stacey T. Broecker | Optometrist | 2356 University Ave W, Saint Paul, MN 55114-1897 | 2006-05-24 |
| 1861884579 | The Wayside House, Inc. | Community/Behavioral Health | 2356 University Ave W, Suite 210, Saint Paul, MN 55114-1853 | 2015-03-04 |
| 1942625413 | Axis Healthcare | Case Management | 2356 University Ave W, Suite 210, Saint Paul, MN 55114-1853 | 2014-02-20 |
| 1053679381 | Lois Foehringer | Registered Nurse | 2356 University Ave W, Suite 210, Saint Paul, MN 55114-1853 | 2012-04-24 |
| 1699926170 | Renita Wilson | Social Worker | 2356 University Ave W, Suite 220, Saint Paul, MN 55114-1853 | 2008-10-02 |
| 1033367057 | The African American Adoption Agency | Community/Behavioral Health | 2356 University Ave W, Suite 220, Saint Paul, MN 55114-1853 | 2008-09-03 |
| 1326215153 | Axis Healthcare | Case Management | 2356 University Ave W, Saint Paul, MN 55114-1853 | 2008-05-12 |
| 1144439134 | Judith Ann Tauer | Nurse Practitioner | 2356 University Ave W, Suite 210, Saint Paul, MN 55114-1853 | 2007-05-22 |
| 1770656845 | Kristin R. Swenson | Optometrist | 2356 University Ave W, Saint Paul, MN 55114-1853 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
| 1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
| 1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
| 1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
| 1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
| 1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
| 1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
| 1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
| 1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
| 1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
| Find all providers in zip 55114 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699399592 | Nicole Rene Schmiedt | Optometrist | 400 Selby Ave Apt 221, Saint Paul, MN 55102-4509 | 2020-06-05 |
| 1982247870 | Lauren K Haverly LLC | Optometrist | 272 Snelling Ave S Ste 300, Saint Paul, MN 55105-2045 | 2019-10-23 |
| 1124506852 | Amanda Mcmullen | Optometrist | 2716 Lincoln Dr, Saint Paul, MN 55113-1333 | 2018-08-03 |
| 1306218995 | Village Eye Care LLC | Optometrist | 1001 Johnson Pkwy Ste B15, Saint Paul, MN 55106-3696 | 2015-10-22 |
| 1326488008 | Matthew K Anderson | Optometrist | 506 7th St W, Saint Paul, MN 55102 | 2013-06-26 |
| 1518232149 | Solomon M Gould | Optometrist | 1995 Burns Ave Ste B, Saint Paul, MN 55119-4906 | 2012-03-15 |
| 1912224767 | The Spectacle Shoppe Inc | Optometrist | 1089 Grand Ave, Saint Paul, MN 55105-3002 | 2010-05-03 |
| 1740515832 | Gaile Kristine Philipp | Optometrist | 3001 White Bear Ave N Ste 1050, Saint Paul, MN 55109-1283 | 2009-10-07 |
| 1982769501 | Calvin Optometry Pllc | Optometrist | 1995 Burns Ave., Suite B, Saint Paul, MN 55119-4906 | 2006-12-26 |
| 1194884635 | Troy E Randgaard | Optometrist | 2034 Ford Pkwy, Saint Paul, MN 55116-1931 | 2006-12-08 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55114 |
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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.