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THE SPECTACLE SHOPPE INC
NPI 1912224767
Optometrist in Saint Paul, MN

Active since May 03, 2010
1089 GRAND AVE, SAINT PAUL, MN 55105(651) 797-4834(651) 788-9153 Get Directions Write a Review

NPPES record last updated: April 11, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About The Spectacle Shoppe Inc NPPES

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

THE SPECTACLE SHOPPE INC (NPI 1912224767) is a healthcare organization registered as an optometrist in Saint Paul, Minnesota and active in the NPI registry since May 2010. The organization lists David Ulrich, Owner, as its authorized official.

NPPES Registry Identity

NPI1912224767
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameTHE SPECTACLE SHOPPE INC
Location Address1089 GRAND AVESaint Paul, MN 55105-3002
Mailing Address1089 Grand AveSaint Paul, MN 55105-3002 · (651) 797-4834 · Fax (651) 788-9153
Phone(651) 797-4834
Fax(651) 788-9153
Organization SubpartYes
Authorized OfficialDavid UlrichOwner · (651) 636-3434
Enumeration DateMay 3, 2010
Last NPPES UpdateApril 11, 2016
✔ NPI 1912224767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in MN · 0136
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.
1089 GRAND AVE, Saint Paul, MN 55105
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

The Spectacle Shoppe Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to The Spectacle Shoppe Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Jacob Erickson, O.D.
Optometry
NPI 1700370749
1089 GRAND AVE
Saint Paul, MN 55105
(651) 797-4834
✔ PECOS✔ Accepts MedicareSame address
Michael Krysiak, O.D.
Optometry
NPI 1629112198
700 NICOLLET MALL
Minneapolis, MN 55402
(612) 375-2697
✔ PECOS✔ Accepts Medicare6.7 mi
Tyler Baars, OD
Optometry
NPI 1861747305
2405 HENNEPIN AVE
Mpls, MN 55405
(612) 584-4142
✔ PECOS✔ Accepts Medicare7.4 mi
James Brekke, OD
Optometry
NPI 1134291487
7150 VALLEY CREEK PLZ SUITE 216
Woodbury, MN 55125
(651) 738-4886
✔ PECOS✔ Accepts Medicare9.1 mi
Timothy Nelson, OD
Optometry
NPI 1215091616
11330 FOUNTAINS DR
Maple Grove, MN 55369
(763) 494-8063
✔ PECOS✔ Accepts Medicare17 mi
Angella Schaefer, O.D.
Optometry
NPI 1073900718
1575 20TH ST NW SUITE 101
Faribault, MN 55021
(507) 332-9900
✔ PECOS✔ Accepts Medicare44 mi
Lee Schneider, O.D.
Optometry
NPI 1598114530
1544 GREENVIEW DR SW
Rochester, MN 55902
(507) 287-2711
✔ PECOS✔ Accepts Medicare73 mi
Wing Yip, OD
Optometry
NPI 1114373560
3241 S MICHIGAN AVE
Chicago, IL 60616
(312) 949-7751
✔ PECOS✔ Accepts Medicare351 mi

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

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 The Spectacle Shoppe Inc's NPI number?

The NPI number for The Spectacle Shoppe Inc is 1912224767. It was assigned to this organization in the NPPES registry on May 3, 2010.

Where is The Spectacle Shoppe Inc located?

The Spectacle Shoppe Inc is located at 1089 Grand Ave, Saint Paul, MN 55105. The listed phone number is (651) 797-4834.

What is The Spectacle Shoppe Inc's specialty?

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

Is The Spectacle Shoppe Inc enrolled in Medicare?

Yes. The Spectacle Shoppe Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through The Spectacle Shoppe Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Optometry, reassign their Medicare billing to The Spectacle Shoppe Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does The Spectacle Shoppe Inc accept?

Health plans from HealthPartners list The Spectacle Shoppe Inc 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 The Spectacle Shoppe Inc was last updated on April 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.