Provider Demographics
NPI:1215934880
Name:JAMES J HESS & SCOTT ENDRES
Entity type:Organization
Organization Name:JAMES J HESS & SCOTT ENDRES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:763-537-3213
Mailing Address - Street 1:5200 DOUGLAS DR N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3104
Mailing Address - Country:US
Mailing Address - Phone:763-537-3213
Mailing Address - Fax:763-537-6732
Practice Address - Street 1:5200 DOUGLAS DR N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55429-3104
Practice Address - Country:US
Practice Address - Phone:763-537-3213
Practice Address - Fax:763-537-6732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3117442152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN144823400OtherMA - DISP
MN101878OtherUCARE SRS ANDMN
MN10184LUOtherBLUE CROSS/BLUE SHIELD
MN21-15970OtherMEDICA CHOICE DISP
MN615OtherHEALTH PARTNERS
MN130829OtherCOLE MANAGED VISION
MN419272900Medicaid
MNCK7217OtherMEDICARE RAILROAD
MN101878OtherUCARE SRS ANDMN
MNC01328Medicare PIN