Individual
DR. ROGER LEE RENGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
700 VILLAGE CENTER DR, SUITE 180, NORTH OAKS, MN 55127-3019
(651) 482-1959
(651) 482-1850
Mailing address
700 VILLAGE CENTER DR, SUITE 180, NORTH OAKS, MN 55127-3019
(651) 482-1959
(651) 482-1850
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1622
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157859294
NPI NUMBER
MN
01
—
21326
HEALTHPARTNERS
MN
01
—
22-02741
MEDICA
MN
01
—
580000012
MEDICARE PTAN
MN
01
—
65138
MEDICARE TAX ID
MN
05
—
754723400
—
MN
01
—
965040671001
PREFERRED ONE
MN
01
—
OB800RE
BLUE CROSS/ BLUE SHIELD
MN
01
—
SC1009
SELECT CARE
MN
Enumeration date
07/06/2006
Last updated
12/12/2009
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