Broecker Eye & Optical
NPI 1114962529ActiveOrganization· Optometrist· Saint Paul, MN
Optometrist in Saint Paul, Minnesota, registered in NPPES in June 2006. The authorized official on file is Stacey T. Broecker, O.D., Optometrist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1114962529 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 19, 2006 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 2108 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
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