DR. KRISTINA M BORESPUPP OD
NPI 1831159680
Optometrist in Plymouth, MN
NPI Status: Active since March 24, 2006
Contact Information
4455 HIGHWAY 169 N
PLYMOUTH, MN
ZIP 55442
Phone: (763) 551-0529
Fax: (763) 559-6010
- Individual
- Female
- Years of Experience 32
- Optometrist
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About KRISTINA BORESPUPP
This page provides the complete NPI Profile along with additional information for Kristina Borespupp, a provider established in Plymouth, Minnesota with a medical specialization in Optometrist and more than 32 years of experience. She graduated from University Alabama Birmingham - School Of Optometry in 1994. The healthcare provider is registered in the NPI registry with number 1831159680 assigned on March 2006. The practitioner's primary taxonomy code is 152W00000X with license number 2479 (MN). The provider is registered as an individual and her NPI record was last updated 18 years ago.
- NPI
- 1831159680
- Provider Name
- DR. KRISTINA M BORESPUPP OD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4455 HIGHWAY 169 N PLYMOUTH, MN 55442
- Location Phone
- (763) 551-0529
- Location Fax
- (763) 559-6010
- Mailing Address
- 3715 MARSH PT W INDEPENDENCE, MN 55359
- Mailing Phone
- (763) 479-3794
- Medical School Name
- UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
- Graduation Year
- 1994
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-24-2006
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 2479
- License State
- MN
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Atlas $1,000 Gold - PPO
- Atlas $1,500 Standard Gold - PPO
- Atlas $2,650 Plus Silver - PPO
- Atlas $3,500 HSA Silver - PPO
- Atlas $5,000 Standard Silver - PPO
- Atlas $6,500 Plus Bronze - PPO
- Atlas $7,500 Standard Bronze - PPO
- Atlas $8,200 HSA Bronze - PPO
- Atlas $9,200 Catastrophic - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - EPO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - EPO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - EPO
- Medica Individual Choice Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| U54141 | MEDICARE UPIN (02) | MN |
Medicare Participation & PECOS Enrollment Status
Kristina Borespupp is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Kristina Borespupp is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4082654132
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20050509000028
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient complete exam of visual system
Established patient problem focused exam of visual system
Exam of visual field with extended testing
Imaging of optic nerve
Imaging of retina
New patient complete exam of visual system
Photography of the retina
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 121 times for 121 patientsThis is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
This service was performed 36 times for 27 patientsAn extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
This service was performed 95 times for 83 patientsImaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
This service was performed 14 times for 14 patientsImaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
This service was performed 24 times for 22 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 29 times for 29 patientsPhotography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
This service was performed 51 times for 50 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.9 for a new patient copayment and $17.43 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 55442 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $127.61
- Minimum New Patient Price $56
- Maximum New Patient Price $168.28
- Average New Patient Copayment $31.9
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.07
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.74
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $138.04
- Average Established Patient Copayment $17.43
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $34.51
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Diabetes: Eye Exam | 100% | 139 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy | 98% | 45 |
| Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months | ||
| Documentation of Current Medications in the Medical Record | 100% | 2080 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| e-Prescribing | 97% | 212 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Screening for Future Fall Risk | 55% | 392 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Medication Reconciliation | 99% | 702 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 90% | 2358 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Practice Improvements for Bilateral Exchange of Patient Information | Yes | N/A |
| Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 86% | 179 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 100% | 86 |
| Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months | ||
| Provide Patient Access | 94% | 2358 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 0% | 2358 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 3 | 1 | 1 | 5 | 9 | 6 | 8 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 6 | 1 | 2 | 5 | 18 | 6 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 6 + 1 + 2 + 5 + 1 + 8 + 6 + 1 + 6 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1831159680 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 15 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1518928845 | DR. TIMOTHY J HURLEY OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 551-0529 |
| 1942378468 | DR. KRISTA M DAVIS OD, FAAO Individual | Optometrist | 4455 HIGHWAY 169 N FOUR SEASONS EYECARE PLYMOUTH, MN 55442 (763) 559-7358 |
| 1376988543 | DR. JOSEPH DALE OSBORNE D.C. Individual | Chiropractor | 4455 HIGHWAY 169 N #200 PLYMOUTH, MN 55442 (763) 557-9032 |
| 1740627017 | OSBORNE CHIROPRACTIC PA Organization | Chiropractor | 4455 HIGHWAY 169 N SUITE 200 PLYMOUTH, MN 55442 (763) 557-9032 |
| 1285695528 | DR. THOMAS J BRYAN OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1427018266 | DR. DONALD H SEALOCK OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1477545895 | VALENTINI CHIROPRACTIC CLINIC LTD PA Organization | Chiropractor | 4455 HIGHWAY 169 N #200 PLYMOUTH, MN 55442 (763) 557-9032 |
| 1497785620 | DON SEALOCK, O.D., P.A. Organization | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1457840191 | LEAH RUHLAND OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1700864279 | TANYA S ERNTSON OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1831829100 | BRYCE D SEALOCK OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1760652036 | JOHN KENNETH VALENTINI D.C. Individual | Chiropractor | 4455 HIGHWAY 169 N STE 200 PLYMOUTH, MN 55442 (763) 557-9032 |
| 1073181574 | NICOLE ANN SOLEM OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1770106635 | LINDSAY NICOLE PAGE OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
| 1023853363 | GRANT SEALOCK OD Individual | Optometrist | 4455 HIGHWAY 169 N PLYMOUTH, MN 55442 (763) 559-7358 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1831159680, enumerated in the NPI registry as an "individual" on March 24, 2006
The provider is located at 4455 Highway 169 N Plymouth, Mn 55442 and the phone number is (763) 551-0529
The provider's speciality is Optometrist with taxonomy code 152W00000X
The provider has more than 32 years of experience. She graduated from University Alabama Birmingham - School Of Optometry in 1994.
The provider might be accepting Accepts: HealthPartners, Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $127.61 with an average copayment of $31.9 for new patient appointments. Established patients should expect a typical charge of $69.74 and an average copayment of 17.43. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient complete exam of visual system, Established patient problem focused exam of visual system, Exam of visual field with extended testing, Imaging of optic nerve, Imaging of retina, New patient complete exam of visual system and Photography of the retina.
This NPI record was last updated on March 24, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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