MINNESOTA EYE CONSULTANTS, PA (NPI# 1104146265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104146265 |
| Entity Type | Organization |
| Organization Name | MINNESOTA EYE CONSULTANTS, PA |
| Practice Address |
11091 Ulysses St Ne Suite 300 Blaine MN 55434-4237 |
| Mailing Address |
9801 Dupont Ave S Suite 425 Bloomington MN 55431-3100 |
| Practice Telephone | 9528885800 |
| Practice Fax Number | 7634218297 |
| Mailing Telephone | 9528885800 |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | BRENT L WILDE (PRESIDENT) |
| Authorized Official Telephone | 9525676143 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 207W00000X | Ophthalmology | 31920 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | CLIA | 24D2023184 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932173374 | Minnesota Eye Consultants, Pa | Optometrist | 10709 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-5509 | 2006-02-14 |
| 1861465064 | Minnesota Eye Consultants, Pa | Optometrist | 1965 11th Ave E, Suite 102, Maplewood, MN 55109-5167 | 2006-02-08 |
| 1326019829 | Minnesota Eye Consultants, Pa | Eyewear Supplier (Equipment, not the service) | 9801 Dupont Ave South, Suite 200, Bloomington, MN 55431-3180 | 2006-02-01 |
| 1467815357 | Minnesota Eye Consultants, Pa | Optometrist | 1347 Larpenteur Ave W, Falcon Heights, MN 55113-6302 | 2016-03-30 |
| 1952452674 | Minnesota Eye Consultants, Pa | Optometrist | 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 | 2007-01-16 |
| 1205930542 | Minnesota Eye Consultants, Pa | Optometrist | 9801 Dupont Ave S, Suite 425, Bloomington, MN 55431-3100 | 2006-09-08 |
| 1174596399 | Minnesota Eye Consultants, Pa | Ophthalmology | 710 E 24th St, Suite 103, Minneapolis, MN 55404-3840 | 2006-02-08 |
| 1508839879 | Minnesota Eye Consultants, Pa | Optometrist | 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 | 2006-02-08 |
| 1477526747 | Minnesota Eye Consultants, Pa | Optometrist | 710 E 24th St, Suite 100, Minneapolis, MN 55404-3840 | 2006-02-08 |
| Street Address |
11091 ULYSSES ST NE SUITE 300 |
| City | BLAINE |
| State | MN |
| Zip Code | 55434-4237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417976077 | Chad D. Evans | Psychiatry & Neurology | 11091 Ulysses St Ne, Suite 100, Blaine, MN 55407 | 2006-07-18 |
| 1295261105 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 11091 Ulysses St Ne, Suite 100, Blaine, MN 55434-4237 | 2017-05-11 |
| 1912199787 | Christine Ann Ebbers-furmanek | Psychiatry & Neurology | 11091 Ulysses St Ne, Suite 100, Blaine, MN 55434 | 2007-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447205810 | Mary Bhavsar | Ophthalmology | 10961 Club West Pkwy, Suite 130, Blaine, MN 55449-5866 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290486 | Eye Care Associates, Pa | Ophthalmology | 710 E 24th St Ste 101-201, Minneapolis, MN 55404-3840 | 2018-10-12 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1790228294 | Eye Associates of Central Minnesota Pa | Ophthalmology | 628 Roosevelt Rd, Suite 101, Saint Cloud, MN 56301-4867 | 2016-12-01 |
| 1093160491 | Christina Gillmor | Ophthalmology | 516 Delaware St Se Fl 9, Minneapolis, MN 55455-0356 | 2016-05-04 |
| 1861889776 | Michael Andrew Jordan | Ophthalmology | 825 Nicollet Mall Ste 2000, Minneapolis, MN 55402-2708 | 2015-04-17 |
| 1467872390 | Luke Dolezal | Ophthalmology | 5851 Duluth St Ste 215, Golden Valley, MN 55422-3956 | 2014-04-17 |
| 1811330939 | James Layer | Ophthalmology | 3708 Upton Ave S, Minneapolis, MN 55410-1237 | 2013-04-08 |
| 1093058158 | Hao Tang | Ophthalmology | 7760 France Ave S Ste 310, Edina, MN 55435 | 2013-03-27 |
| 1407112881 | Phillip Michael Armand Radke | Ophthalmology | 7450 France Ave S Ste 100, Edina, MN 55435-4799 | 2012-04-10 |
| 1023374964 | Sasha Strul | Ophthalmology | 701 25th Ave S Ste 300, Minneapolis, MN 55454-1443 | 2012-04-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.