Distinctive Eyewear, LLC
NPI 1457690133ActiveOrganization· Technician/Technologist, Optician· Golden Valley, MN
Technician/Technologist, Optician in Golden Valley, Minnesota, registered in NPPES in January 2013. The authorized official on file is Kelly Pettengill, Credentialing And Data Management. Enrolled in Medicare as dme supplier - optician.
Overview
| NPI | 1457690133 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 31, 2013 |
| Last updated in NPPES | Mar 18, 2020 |
| Certified by provider | Mar 18, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Technician/Technologist, Optician Primary | 156FX1800X | — | MN |
| Technician/Technologist, Contact Lens | 156FC0800X | — | MN |
| Eyewear Supplier (Equipment, not the service) | 332H00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Optician (MN) |
|---|