| In House Senior Services, Llc | |
|
6625 Lyndale Ave S Ste 105, Richfield, MN 55423-2673 | |
| (612) 788-8778 | |
| (612) 869-3473 |
| Full Name | In House Senior Services, Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 6625 Lyndale Ave S Ste 105, Richfield, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083962294 | NPI | - | NPPES |
| 1083962294 | Medicaid | WI | |
| 1083962294 | Medicaid | MN | |
| C09267 | Other | MN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 213E00000X | Podiatrist | 631 (Minnesota) | Primary |
| 231H00000X | Audiologist | (* (Not Available)) | Secondary |
| Provider Name | Dale Herbert Vancil |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1205856713 PECOS PAC ID: 5395649578 Enrollment ID: I20031120000214 |
| Provider Name | Mark D Homstad |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1043289580 PECOS PAC ID: 2264346923 Enrollment ID: I20040329000357 |
| Provider Name | Michael Debrule |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1689655722 PECOS PAC ID: 4082695747 Enrollment ID: I20040527001000 |
| Provider Name | Scott C Knutson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1679578157 PECOS PAC ID: 3779528831 Enrollment ID: I20060425000406 |
| Provider Name | Glenn R Meints |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1265514731 PECOS PAC ID: 2062512304 Enrollment ID: I20070716000272 |
| Provider Name | Dana Brewington |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1205933553 PECOS PAC ID: 5294735239 Enrollment ID: I20071018000104 |
| Provider Name | Bryan Mohr |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1043215528 PECOS PAC ID: 8527070937 Enrollment ID: I20080602000712 |
| Provider Name | David Edward Jones |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639163405 PECOS PAC ID: 6507824778 Enrollment ID: I20110203001135 |
| Provider Name | Eric W Affeldt |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225144850 PECOS PAC ID: 6709062698 Enrollment ID: I20110510000474 |
| Provider Name | Martha S Takata |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1659631349 PECOS PAC ID: 2163659210 Enrollment ID: I20131216001554 |
| Provider Name | Mary E Jaeger |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1891129425 PECOS PAC ID: 4385867142 Enrollment ID: I20140523000225 |
| Provider Name | Allison C Werler |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1831565092 PECOS PAC ID: 9638486764 Enrollment ID: I20150922000836 |
| Provider Name | Amanda A Pojanowski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528310869 PECOS PAC ID: 6507165255 Enrollment ID: I20160502000002 |
| Provider Name | Kirsten Marie Scott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821340159 PECOS PAC ID: 1052699469 Enrollment ID: I20161104001010 |
| Provider Name | Deneen Zaetta |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346372125 PECOS PAC ID: 4789877689 Enrollment ID: I20161209001599 |
| Provider Name | Eric Nelson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1184028193 PECOS PAC ID: 4880963628 Enrollment ID: I20170710002846 |
| Provider Name | Judith Demorest |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1720252018 PECOS PAC ID: 7517025273 Enrollment ID: I20170926002748 |
| Provider Name | Karimah Z Shabazz |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1134412802 PECOS PAC ID: 3577881697 Enrollment ID: I20180612000561 |
| Provider Name | Todd Aaron Peabody |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750720876 PECOS PAC ID: 9739471939 Enrollment ID: I20180731000630 |
| Provider Name | Brent James Larson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659759082 PECOS PAC ID: 2062762479 Enrollment ID: I20180906000273 |
| Provider Name | Lisa M Thatcher |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1922450618 PECOS PAC ID: 2365785904 Enrollment ID: I20190522000663 |
| Provider Name | Marlene Bonilla Alicea |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588856546 PECOS PAC ID: 9436316817 Enrollment ID: I20190613000730 |
| Provider Name | Darrick William Proehl |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1629417506 PECOS PAC ID: 2365768504 Enrollment ID: I20191008000107 |
| Provider Name | Kristofor Kalvig |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558898114 PECOS PAC ID: 9638595267 Enrollment ID: I20200813001683 |
| Provider Name | Mary T Trainor |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1467061085 PECOS PAC ID: 5395702849 Enrollment ID: I20201205000250 |
| Provider Name | Amanda Mcguire |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1124470745 PECOS PAC ID: 9335478015 Enrollment ID: I20210610002219 |
| Provider Name | Nicholas Staub |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790274066 PECOS PAC ID: 8921404690 Enrollment ID: I20210903000541 |
| Provider Name | Tran Bao Nguyen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1326600123 PECOS PAC ID: 7911389051 Enrollment ID: I20220805000281 |
| Provider Name | Michael Lee Vallez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215440854 PECOS PAC ID: 5294106977 Enrollment ID: I20230116000981 |
| Provider Name | Linda Logan |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1689710956 PECOS PAC ID: 6800999673 Enrollment ID: I20230621000083 |
| Provider Name | John Matthew Thomas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1033471990 PECOS PAC ID: 9032417829 Enrollment ID: I20230831002859 |
| Mailing Address | Practice Location Address |
|---|---|
| In House Senior Services, Llc 6625 Lyndale Ave S Ste 300, Richfield, MN 55423-2491 Ph: (612) 243-8999 | In House Senior Services, Llc 6625 Lyndale Ave S Ste 105, Richfield, MN 55423-2673 Ph: (612) 788-8778 |
Midwest Podiatry Centers Pllc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 6600 Lyndale Ave S, Suite 150, Richfield, MN 55423 Phone: 612-788-8778 Fax: 612-869-3473 | |
John M Thomas, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6625 Lyndale Ave S Ste 105, Richfield, MN 55423 Phone: 612-788-8778 Fax: 612-869-3473 | |
Mr. Bryan Mohr, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6625 Lyndale Ave S Ste 105, Richfield, MN 55423 Phone: 612-788-8778 Fax: 612-869-3473 | |
Dr. Mark Dennis Homstad, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6625 Lyndale Ave S Ste 105, Richfield, MN 55423 Phone: 612-788-8778 | |
Amanda Mcguire, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6625 Lyndale Ave S Ste 105, Richfield, MN 55423 Phone: 612-788-8778 Fax: 612-869-3473 | |
Dr. Timothy J Szopa, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 407 W 66th St, Richfield, MN 55423 Phone: 612-798-8800 Fax: 612-798-8816 | |
Dr. Karimah Z Shabazz, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6600 Lyndale Ave S Ste 130, Richfield, MN 55423 Phone: 612-788-8778 |