Provider Demographics
NPI:1033281597
Name:ELAINE HAPP OD PA
Entity Type:Organization
Organization Name:ELAINE HAPP OD PA
Other - Org Name:UPTOWN EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING ASSOC
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-271-2020
Mailing Address - Street 1:560 CEDAR STREET
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-8403
Mailing Address - Country:US
Mailing Address - Phone:763-271-2020
Mailing Address - Fax:763-271-2030
Practice Address - Street 1:560 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-8403
Practice Address - Country:US
Practice Address - Phone:763-271-2020
Practice Address - Fax:763-271-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN93581OtherPREFERRED ONE
MN2112069OtherMEDICA
MN51725OtherHEALTHPARTNERS
MN5C2094HAOtherBCBS
MNDD00364OtherMEDICARE RAILROAD
MN2112069OtherSELECTCARE
MN663827900Medicaid
MND678OtherUCARE
MND678OtherUCARE
MN2112069OtherSELECTCARE