SOUTHDALE OPTICAL CO
NPI 1871576306
Eyewear Supplier in Edina, MN

Active since November 29, 2005
6533 DREW AVE S, EDINA, MN 55435(952) 925-9550(952) 925-9748 Get Directions Write a Review

NPPES record last updated: June 16, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southdale Optical Co NPPES

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

SOUTHDALE OPTICAL CO (NPI 1871576306) is a healthcare organization registered as an eyewear supplier in Edina, Minnesota and active in the NPI registry since November 2005. The organization lists Bradley Jon Peterson, President, as its authorized official.

NPPES Registry Identity

NPI1871576306
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSOUTHDALE OPTICAL CO
Location Address6533 DREW AVE SEdina, MN 55435-2103
Mailing Address6533 Drew Ave SEdina, MN 55435-2103 · (952) 925-9550 · Fax (952) 925-9748
Fax(952) 925-9748
Organization SubpartNo
Authorized OfficialBradley Jon PetersonPresident · (952) 925-9550
Enumeration DateNovember 29, 2005
Last NPPES UpdateJune 16, 2009
NPI 1871576306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

6533 DREW AVE S, Edina, MN 55435

Other Identifiers 1

Medicare NSC0283180001MN

Accepted Insurance

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Southdale Optical Co carries, from the Medicare DMEPOS supplier directory.

Southdale Optical Co

DMEPOS supplier · Edina, MN

Accepts Medicare assignment

Southdale Optical Co agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20622731
Medicare Participant SinceJanuary 1, 2001
Supplier Location6533 Drew Ave SoEdina, MN 55435
Supplier Specialties
Optician

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Prosthetic Lenses: Prosthetics Cataract Lenses
Cataract Eyeglasses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 13

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

Ophthalmology
6533 DREW AVE S
EDINA, MN 55435
Ophthalmology
6533 DREW AVE S
EDINA, MN 55435
Ophthalmology
6533 DREW AVE S
EDINA, MN 55435
Ophthalmology
6533 DREW AVE S
EDINA, MN 55435
Ophthalmology
6533 DREW AVE S
EDINA, MN 55435
Ophthalmology
6533 DREW AVE S
EDINA, MN 55435
Ophthalmology
6533 DREW AVE S
EDINA, MN 55435
Ophthalmology
6533 DREW AVE S
EDINA, MN 55435

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southdale Optical Co's NPI number?

The NPI number for Southdale Optical Co is 1871576306. It was assigned to this organization in the NPPES registry on November 29, 2005.

Where is Southdale Optical Co located?

Southdale Optical Co is located at 6533 Drew Ave S, Edina, MN 55435. The listed phone number is (952) 925-9550.

What is Southdale Optical Co's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Does Southdale Optical Co accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Southdale Optical Co accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Southdale Optical Co accept?

Health plans from Medica list Southdale Optical Co as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southdale Optical Co was last updated on June 16, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.