| Pinecone Vision Center, Pa | |
|
2180 Troop Dr, Sartell, MN 56377-7504 | |
| (320) 258-3915 | |
| (320) 258-3917 |
| Full Name | Pinecone Vision Center, Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2180 Troop Dr, Sartell, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790830701 | NPI | - | NPPES |
| 1790830701 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2617 (Minnesota) | Primary |
| Provider Name | Nicholas Colatrella |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467507475 PECOS PAC ID: 2860382967 Enrollment ID: I20040319000869 |
| Provider Name | Stacy M Hinkemeyer-colatrella |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881788016 PECOS PAC ID: 2365332467 Enrollment ID: I20040319000889 |
| Provider Name | Kevy Simmons |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407101892 PECOS PAC ID: 9032360391 Enrollment ID: I20160511002377 |
| Provider Name | Joseph J Allen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023390499 PECOS PAC ID: 9032401997 Enrollment ID: I20160713001619 |
| Provider Name | Shalon A Ronning |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770010613 PECOS PAC ID: 1052688652 Enrollment ID: I20170602001136 |
| Provider Name | Trevor James Fosso |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336597079 PECOS PAC ID: 3577854264 Enrollment ID: I20170809002957 |
| Provider Name | Brett Michael Hollenbach |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669953873 PECOS PAC ID: 7416283312 Enrollment ID: I20190731000073 |
| Provider Name | Sydney Athmann |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316677925 PECOS PAC ID: 5092196048 Enrollment ID: I20220721002398 |
| Provider Name | Alyssa Judell Richard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699466284 PECOS PAC ID: 0042677395 Enrollment ID: I20230601001846 |
| Provider Name | Hunter Riley Throndsen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447073796 PECOS PAC ID: 0042747396 Enrollment ID: I20241226002670 |
| Mailing Address | Practice Location Address |
|---|---|
| Pinecone Vision Center, Pa 2180 Troop Dr, Sartell, MN 56377-4563 Ph: (320) 258-3915 | Pinecone Vision Center, Pa 2180 Troop Dr, Sartell, MN 56377-7504 Ph: (320) 258-3915 |
Kelly Noel Freese, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 2380 Troop Dr, Suite201, Sartell, MN 56377 Phone: 320-258-3915 Fax: 320-258-3917 | |
Sydney Athmann, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2180 Troop Dr, Sartell, MN 56377 Phone: 320-258-3915 Fax: 320-258-3917 | |
Trevor J Fosso, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2180 Troop Dr, Sartell, MN 56377 Phone: 320-258-3915 Fax: 320-258-3917 | |
Hunter Riley Throndsen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2180 Troop Dr, Sartell, MN 56377 Phone: 320-258-3915 | |
Dr. Nicholas Colatrella, O.D. FAAO Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2180 Troop Dr, Sartell, MN 56377 Phone: 320-258-3915 Fax: 320-258-3917 | |
Pinecone Vision Center Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2180 Troop Drive, Sartell, MN 56377 Phone: 320-258-3915 Fax: 320-258-3917 | |
Alyssa Judell Richard, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2180 Troop Dr, Sartell, MN 56377 Phone: 320-258-3915 |