ANDOVER OPTICAL INC (NPI# 1972663383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972663383 |
| Entity Type | Organization |
| Organization Name | ANDOVER OPTICAL INC |
| Practice Address |
13855 Round Lake Blvd Nw Andover MN 55304-3664 |
| Practice Telephone | 7634210141 |
| Practice Fax Number | 7634210334 |
| Mailing Telephone | 7634210141 |
| Mailing Fax Number | 7634210334 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2008-02-06 |
| Authorized Official Name | MS. LAINE SANGREN (VICE PRES) |
| Authorized Official Telephone | 7634210141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FC0800X |
Technician/Technologist Specialization: Contact Lens |
Eye and Vision Services Providers | ||
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| Y | 156FC0801X |
Technician/Technologist Specialization: Contact Lens Fitter |
Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | PREFERREDONE | 747001 | 01 |
| MN | HEALTH PARTNERS | 16125 | 01 |
| MN | UCARE | 114915 | 01 |
| MN | BCBS | 10294AN | 01 |
| MN | MEDICA | 2115818 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417133208 | Andover Optical Inc | Durable Medical Equipment & Medical Supplies | 42 Main St, Andover, MA 01810-3733 | 2008-01-11 |
| Street Address |
13855 ROUND LAKE BLVD NW |
| City | ANDOVER |
| State | MN |
| Zip Code | 55304-3664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215933213 | Don J Herve | Optometrist | 13855 Round Lake Blvd Nw, Andover, MN 55304-3664 | 2005-06-23 |
| 1376750869 | Don J Herve, O.d., P.C. | Optometrist | 13855 Round Lake Blvd Nw, Andover, MN 55304-3664 | 2007-05-16 |
| 1952461352 | Jeffrey E Smith | Optometrist | 13855 Round Lake Blvd Nw, Andover, MN 55304-3664 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114402211 | Sarah Sue Anderson | Speech-Language Pathologist | 1891 Station Pkwy, Andover, MN 55304 | 2018-09-25 |
| 1306354329 | Jennifer Lynn Larkey I | Counselor | 1875 Station Parkway N.w. Andover, Mn 55304, Andover, MN 55304 | 2018-01-11 |
| 1124544895 | Msp Dentistry Inc | Preferred Provider Organization | 13650 Hanson Blvd., Suite #110, Andover, MN 55304 | 2017-08-15 |
| 1912427931 | Brooke Nicole Halliday | Counselor | 1875 Station Pkwy Ne, Andover, MN 55304 | 2017-06-21 |
| 1700286903 | Jari Welle, Inc. | Marriage & Family Therapist | 1328 Mckay Drive Ne, Suite 100, Ham Lake, MN 55304 | 2014-08-26 |
| 1356765192 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1889 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1326462177 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1899 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1740619568 | Delores Weikle | Physical Therapist | 14531 Jay St, Andover, MN 55304 | 2013-11-02 |
| 1730527003 | Darkou Care Services | Home Health | 14297 Zilla Street Nw, Andover, MN 55304 | 2013-06-10 |
| 1770927758 | Arbor Oaks Senior Living | Assisted Living Facility | 1640 155th Lane Nw, Andover, MN 55304 | 2013-04-22 |
| Find all providers in zip 55304 | ||||
| Taxonomy Code | 156FC0801X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Contact Lens Fitter |
| An optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447491584 | Northwest Opticians Inc | Technician/Technologist | 367 Wabasha St N, Saint Paul, MN 55102-1305 | 2009-03-19 |
| 1275827107 | Jaj Eyewear Inc. | Technician/Technologist | 740 Main St, Suite 100, Mendota Heights, MN 55118-3762 | 2011-06-08 |
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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.