DR. JESSE ROSSOW O.D.
NPI 1649617614
Optometrist in Plymouth, MN

Q: What is Jesse Rossow's NPI number?

The NPI number for Jesse Rossow is 1649617614. It was assigned to this individual provider in the NPPES registry on May 30, 2013.

Q: What is Jesse Rossow's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jesse Rossow was last updated on May 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 30, 2013PECOS EnrolledAccepts Medicare Assignment

10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441(763) 545-8850(763) 544-1257 Get Directions Write a Review

NPPES record last updated: May 31, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Jesse Rossow O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JESSE ROSSOW O.D. (NPI 1649617614) is an individual optometrist in Plymouth, Minnesota, licensed in Minnesota (3330) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS and is a graduate of Ferris State College - College Of Optometry (2013).

NPPES Registry Identity

NPI1649617614

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. JESSE ROSSOWCredential: O.D.

Location Address10600 OLD COUNTY ROAD 15Plymouth, MN 55441-6200

Mailing Address10600 Old County Road 15Plymouth, MN 55441-6200 · (763) 545-8850 · Fax (763) 544-1257

Phone(763) 545-8850

Fax(763) 544-1257

Sole ProprietorNo

Medical School CMSFerris State College - College Of OptometryGraduated 2013

Enumeration DateMay 30, 2013

Last NPPES UpdateMay 31, 2013

✔ NPI 1649617614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in MN · 3330

Definition

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.

Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X · License 3330 (MN)

Also ListedOptometrist · PediatricsTaxonomy 152WP0200X · License 3330 (MN)

10600 OLD COUNTY ROAD 15, Plymouth, MN 55441

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jesse Rossow O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143469031

PECOS Enrollment IDI20130626000163

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jesse Rossow reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kennedy Vision Health Center, LLC

Same address

Optometrist

10600 OLD COUNTY ROAD 15
Plymouth, MN 55441

Reassigned Medicare billing, Minnesota enrollment
7 clinicians in this Medicare group

NPI 1033203963 (763) 545-8850

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

68 services68 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

56 services37 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

40 services40 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

34 services23 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

34 services26 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

31 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55441 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.61 typical visit price

range $56.00 – $168.28

Typical copayment $31.90 (range $14.00 – $42.07)

Most-billed visit code 99204

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNEDY VISION HEALTH CENTER, LLC

Optometrist