| Roseville Eye Associates P.a. | |
|
3601 Park Center Blvd Apt 607 St Louis Park MN 55416-2562 | |
| (608) 513-0092 | |
| Not Available |
| Full Name | Roseville Eye Associates P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3601 Park Center Blvd Apt 607, St Louis Park, Minnesota |
| Authorized Official Name and Position | Kari Maffitt (OWNER) |
| Authorized Official Contact | 6085130092 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roseville Eye Associates P.a. 1790 Lexington Ave N Roseville MN 55113-6167 Ph: (651) 488-6771 | Roseville Eye Associates P.a. 3601 Park Center Blvd Apt 607 St Louis Park MN 55416-2562 Ph: (608) 513-0092 |
| NPI Number | 1134682669 |
|---|---|
| Provider Enumeration Date | 04/11/2019 |
| Last Update Date | 09/13/2019 |
| Medicare PECOS PAC ID | 6507109642 |
|---|---|
| Medicare Enrollment ID | O20190514000261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134682669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kristin R Swenson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770656845 PECOS PAC ID: 0143117721 Enrollment ID: I20040228000350 |
| Provider Name | Kari Linnae Maffitt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023498474 PECOS PAC ID: 4486931151 Enrollment ID: I20170505001266 |
| Provider Name | Emily L Ellingson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356835748 PECOS PAC ID: 1456690858 Enrollment ID: I20190301001318 |
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