STACEY T. BROECKER O.D.
NPI 1922053040
Optometrist in Saint Paul, MN

Q: What is Stacey Broecker's NPI number?

The NPI number for Stacey Broecker is 1922053040. It was assigned to this individual provider in the NPPES registry on May 24, 2006. The provider is also known as Stacey A. Taylor O.D..

Q: What is Stacey Broecker'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 Stacey Broecker was last updated on November 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 24, 2006PECOS Enrolled

2356 UNIVERSITY AVE W, SAINT PAUL, MN 55114(651) 645-8124(651) 645-8125 Get Directions Write a Review

NPPES record last updated: November 20, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Stacey T. Broecker O.d. NPPES

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

STACEY T. BROECKER O.D. (NPI 1922053040) is an individual optometrist in Saint Paul, Minnesota, licensed in Minnesota (2108) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922053040

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameSTACEY T. BROECKERCredential: O.D.

Location Address2356 UNIVERSITY AVE WSaint Paul, MN 55114-1897

Mailing Address2356 University Ave WSaint Paul, MN 55114-1897 · (651) 645-8124 · Fax (651) 645-8125

Phone(651) 645-8124

Fax(651) 645-8125

Sole ProprietorYes

Enumeration DateMay 24, 2006

Last NPPES UpdateNovember 20, 2018

✔ NPI 1922053040 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 · 2108

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.

2356 UNIVERSITY AVE W, Saint Paul, MN 55114

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Other Names 1

Former Name (1)Stacey A. Taylor O.d.

Other Identifiers 1

Medicaid808023200MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacey T. Broecker O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55114 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 8

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

THE AFRICAN AMERICAN ADOPTION AGENCY

Case Management

2356 UNIVERSITY AVE W, SUITE 220
SAINT PAUL, MN 55114

Ramsey County (651) 659-0460

MS. LOIS FOEHRINGER RN PHN

Registered Nurse (Case Management)

2356 UNIVERSITY AVE W, SUITE 210
SAINT PAUL, MN 55114

Ramsey County (651) 556-9329

BROECKER EYE & OPTICAL

Optometrist

2356 UNIVERSITY AVE W, SUITE 260
SAINT PAUL, MN 55114

Ramsey County (651) 645-8124

MS. JUDITH ANN TAUER RNC,ANP

Nurse Practitioner (Adult Health)

2356 UNIVERSITY AVE W, SUITE 210
SAINT PAUL, MN 55114

Ramsey County (651) 556-0887

AXIS HEALTHCARE

Case Management

2356 UNIVERSITY AVE W
SAINT PAUL, MN 55114

Ramsey County (651) 556-0880

CHANDINI VANG

Counselor (Mental Health)

2356 UNIVERSITY AVE W
SAINT PAUL, MN 55114

Ramsey County (612) 293-8019

KRISTIN R. SWENSON O.D.

Optometrist

2356 UNIVERSITY AVE W
SAINT PAUL, MN 55114

Ramsey County (651) 645-8124

AXIS HEALTHCARE

Case Management

2356 UNIVERSITY AVE W, SUITE 210
SAINT PAUL, MN 55114

Ramsey County (651) 556-0887

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 Stacey Broecker's NPI number?

The NPI number for Stacey Broecker is 1922053040. It was assigned to this individual provider in the NPPES registry on May 24, 2006. The provider is also known as Stacey A. Taylor O.D..

Where is Stacey Broecker located?

Stacey Broecker practices at 2356 University Ave W, Saint Paul, MN 55114. The listed phone number is (651) 645-8124.

What is Stacey Broecker's specialty?

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

Is Stacey Broecker enrolled in Medicare?

Yes. Stacey Broecker is registered in the Medicare PECOS enrollment system.

What insurance does Stacey Broecker accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, BlueCross BlueShield of Tennessee and Medica and 1 other insurer list Stacey Broecker 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 Stacey Broecker was last updated on November 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.